Water incident related hospital activity across England between 1997/8 and 2003/4: a retrospective descriptive study

Every year in the United Kingdom, 10,000 people will die from accidental injury and the treatment of these injuries will cost the NHS £2 billion and the consequences of injuries received at home cost society a further £25 billion [1]. Non-fatal injuries result in 720,000 people being admitted to hospital a year and more than six million visits to accident and emergency departments each year [2]. Drowning is the second leading cause of unintentional injury mortality globally behind road traffic injuries. It is estimated that a total of 409, 272 people drown each year [3]. This equates to a global incident rate of 7.4 deaths per 100, 000 people worldwide and relates to a further 1.3 million Disability Adjusted Life Years (DALYs) which are lost as a result of premature death or disability [4]. 'Death' represents only the tip of the injury "iceberg" [5]. For every life lost from an injury, many more people are admitted to hospital, attend accident and emergency departments or general practitioners, are rescued by search and rescue organisations or resolve the situation themselves. It is estimated that 1.3 million people are injured as a result of near drowning episodes globally and that many more hundreds of thousands of people are affected through incidents and near misses but there are no accurate data [4]. The United Kingdom has reported a variable drowning fatality rate, the injury chart book reports a rate of 1.0 – 1.5 per 100,000 [6] and other studies suggest a rate as low as 0.5 per 100, 000 population [7] for accidental drowning and submersion, based on the International Classification of Disease 10 code W65 – 74, however, the problem is even greater and these Global Burden of Disease (GDB) figures are an underestimate of all drowning deaths, since they exclude drownings due to cataclysms (floods), water related transport accidents, assaults and suicide [3]. A recent study in Scotland highlighted this underestimation in drowning fatality data and found that the overall death rate due to drownings in Scotland 3.26 per 100,000 [8]. Even though drowning fatality rates in the United Kingdom vary, little is known about the people who are admitted to hospital after an incident either in or on water. This paper seeks to address this gap in our knowledge through the investigation of the data available on those admitted to NHS hospitals in England

Improving community health through marketing exchanges: A participatory action research study on water, sanitation, and hygiene in three Melanesian countries

Diseases related to poor water, sanitation and hygiene (WaSH) are major causes of mortality and morbidity. While pursuing marketing approaches to WaSH to improve health outcomes is often narrowly associated with monetary exchange, marketing theory recognises four broad marketing exchange archetypes: market-based, non-market-based, command-based and culturally determined. This diversity reflects the need for parameters broader than monetary exchange when improving WaSH. This study applied a participatory action research process to investigate how impoverished communities in Melanesian urban and peri-urban informal settlements attempt to meet their WaSH needs through marketing exchange. Exchanges of all four archetypes were present, often in combination. Motivations for participating in the marketing exchanges were based on social relationships alongside WaSH needs, health aspirations and financial circumstances. By leveraging these motivations and pre-existing, self-determined marketing exchanges, WaSH practitioners may be able to foster WaSH marketing exchanges consistent with local context and capabilities, in turn improving community physical, mental and social health

Problem gambling and suicidality in England: secondary analysis of a representative cross-sectional survey

Objectives: Problem gamblers in treatment are known to be at high risk for suicidality, but few studies have examined if this is evident in community samples. Evidence is mixed on the extent to which an association between problem gambling and suicidality may be explained by psychiatric comorbidity. We tested whether they are associated after adjustment for co-occurring mental disorders and other factors. Study design: Secondary analysis of the Adult Psychiatric Morbidity Survey 2007, a cross-sectional na- tional probability sample survey of 7403 adults living in households in England. Methods: Rates of suicidality in problem gamblers and the rest of the population were compared. A series of logistic regression models assessed the impact of adjustment on the relationship between problem gambling and suicidality. Results: Past year suicidality was reported in 19.2% of problem gamblers, compared with 4.4% in the rest of the population. Their unadjusted odds ratios (OR) of suicidality were 5.3 times higher. Odds attenuated but remained significant when depression and anxiety disorders, substance dependences, attention- deficit/hyperactivity disorder, and other factors were accounted for (adjusted OR 1⁄4 2.9, 95% confi- dence interval 1⁄4 1. 1, 8.1 P 1⁄4 0.023). Conclusions: Problem gamblers are a high-risk group for suicidality. This should be recognised in indi- vidual suicide prevention plans and local and national suicide prevention strategies. While some of this relationship is explained by other factors, a significant and substantial association between problem gambling and suicidality remains

Iodine binding to humic acid

The rate of reactions between humic acid (HA) and iodide (I-) and iodate (IO3-) have been investigated in suspensions spiked with 129I at concentrations of 22, 44 and 88 µg L-1 and stored at 10oC. Changes in the speciation of 129I-, 129IO3- and mixed (129I-+129IO3-) spikes were monitored over 77 days using liquid chromatography inductively coupled plasma mass spectrometry (LC-ICP-MS). In suspensions spiked with 129I- 25% of the added I- was transformed into organic iodine (Org-129I) within 77 days and there was no evidence of 129IO3- formation. By contrast, rapid loss of 129IO3- and increase in both 129I- and Org-129I was observed in 129IO3--spiked suspensions. However, the rate of Org-129I production was greater in mixed systems compared to 129IO3--spiked suspensions with the same total 129I concentration, possibly indicating IO3-—I- redox coupling. Size exclusion chromatography (SEC) demonstrated that Org-129I was present in both high and low molecular weight fractions of the HA although a slight preference to bond with the lower molecular weight fractions was observed indicating that, after 77 days, the spiked isotope had not fully mixed with the native 127I pool. Iodine transformations were modelled using first order rate equations and fitted rate coefficients determined. However, extrapolation of the model to 250 days indicated that a pseudo-steady state would be attained after ~ 200 days but that the proportion of 129I incorporated into HA was less than that of 127I indicating the presence of a recalcitrant pool of 127I that was unavailable for isotopic mixing

The therapeutic potential of the filarial nematode-derived immunodulator, ES-62 in inflammatory disease

The dramatic recent rise in the incidence of allergic or autoimmune inflammatory diseases in the West has been proposed to reflect the lack of appropriate priming of the immune response by infectious agents such as parasitic worms during childhood. Consistent with this, there is increasing evidence supporting an inverse relationship between worm infection and T helper type 1/17 (Th1/17)-based inflammatory disorders such as rheumatoid arthritis, inflammatory bowel disease, type 1 diabetes and multiple sclerosis. Perhaps more surprisingly, given that such worms often induce strong Th2-type immune responses, there also appears to be an inverse correlation between parasite load and atopy. These findings therefore suggest that the co-evolution of helminths with hosts, which has resulted in the ability of worms to modulate inflammatory responses to promote parasite survival, has also produced the benefit of protecting the host from pathological lesions arising from aggressive proinflammatory responses to infection or, indeed, aberrant inflammatory responses underlying autoimmune and allergic disorders. By focusing upon the properties of the filarial nematode-derived immunomodulatory molecule, ES-62, in this review we shall discuss the potential of exploiting the immunomodulatory products of parasitic worms to identify and develop novel therapeutics for inflammation

Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya

Background: Previous research has linked alcohol use with an increased number of sexual partners, inconsistent condom use and a raised incidence of sexually transmitted infections (STIs). However, alcohol measures have been poorly standardised, with many ill-suited to eliciting, with adequate precision, the relationship between alcohol use and sexual risk behaviour. This study investigates which alcohol indicator - single-item measures of frequency and patterns of drinking (> = 6 drinks on 1 occasion), or the Alcohol Use Disorders Identification Test (AUDIT) - can detect associations between alcohol use and unsafe sexual behaviour among male sex workers. Methods: A cross-sectional survey in 2008 recruited male sex workers who sell sex to men from 65 venues in Mombasa district, Kenya, similar to a 2006 survey. Information was collected on socio-demographics, substance use, sexual behaviour, violence and STI symptoms. Multivariate models examined associations between the three measures of alcohol use and condom use, sexual violence, and penile or anal discharge. Results: The 442 participants reported a median 2 clients/week (IQR = 1-3), with half using condoms consistently in the last 30 days. Of the approximately 70% of men who drink alcohol, half (50.5%) drink two or more times a week. Binge drinking was common (38.9%). As defined by AUDIT, 35% of participants who drink had hazardous drinking, 15% harmful drinking and 21% alcohol dependence. Compared with abstinence, alcohol dependence was associated with inconsistent condom use (AOR = 2.5, 95% CI = 1.3-4.6), penile or anal discharge (AOR = 1.9, 95% CI = 1.0-3.8), and two-fold higher odds of sexual violence (AOR = 2.0, 95% CI = 0.9-4.9). Frequent drinking was associated with inconsistent condom use (AOR = 1.8, 95% CI = 1.1-3.0) and partner number, while binge drinking was only linked with inconsistent condom use (AOR = 1.6, 95% CI = 1.0-2.5). Conclusions: Male sex workers have high levels of hazardous and harmful drinking, and require alcohol-reduction interventions. Compared with indicators of drinking frequency or pattern, the AUDIT measure has stronger associations with inconsistent condom use, STI symptoms and sexual violence. Increased use of the AUDIT tool in future studies may assist in delineating with greater precision the explanatory mechanisms which link alcohol use, drinking contexts, sexual behaviours and HIV transmission

Markets and marketing research on poverty and its alleviation: Summarizing an evolving logic toward human capabilities, well-being goals and transformation

Marketing practitioners and business scholars now view some of the world’s poorest communities as profitable growth markets. Hence a market-based approach to poverty alleviation has gathered momentum. This article traces the evolution of such a market-based approach over four decades and highlights a gradual trend away from a deficit-reduction approach (focused on constraints and justice) towards an opportunity-expansion approach (focused on capabilities and well-being). This trend is summarized in an analytical framework of human capabilities, well-being goals and transformative impact evolved from the literature. The framework is then used to analyse the practice of sanitation marketing, which has emerged as a key method in one of the highest priority domains in international development discourse – sanitation. The article concludes with a discussion of how contemporary work can further take forward the key tenets of the framework and guide the development of ‘good markets’ for the poor

A guide to the contained use of plant virus infectious clones

Plant virus infectious clones are important tools with wide-ranging applications in different areas of biology and medicine. Their uses in plant pathology include the study of plant–virus interactions, and screening of germplasm as part of prebreeding programmes for virus resistance. They can also be modified to induce transient plant gene silencing (Virus Induced Gene Silencing – VIGS) and as expression vectors for plant or exogenous proteins, with applications in both plant pathology and more generally for the study of plant gene function. Plant viruses are also increasingly being investigated as expression vectors for in planta production of pharmaceutical products, known as molecular farming. However, plant virus infectious clones may pose a risk to the environment due to their ability to reconstitute fully functional, transmissible viruses. These risks arise from both their inherent pathogenicity and the effect of any introduced genetic modifications. Effective containment measures are therefore required. There has been no single comprehensive review of the biosafety considerations for the contained use of genetically modified plant viruses, despite their increasing importance across many biological fields. This review therefore explores the biosafety considerations for working with genetically modified plant viruses in contained environments, with focus on plant growth facilities. It includes regulatory frameworks, risk assessment, assignment of biosafety levels, facility features and working practices. The review is based on international guidance together with information provided by plant virus researchers