Residential traffic exposure and children's emergency department presentation for asthma: a spatial study

<p>Abstract</p> <p>Background</p> <p>There is increasing evidence that residential proximity to roadways is associated with an elevated risk of asthma exacerbation. However, there is no consensus on the distance at which these health effects diminishes to background levels. Therefore the optimal, clinically relevant measure of exposure remains uncertain. Using four spatially defined exposure metrics, we evaluated the association between residential proximity to roadways and emergency department (ED) presentation for asthma in Perth, Western Australia.</p> <p>Method</p> <p>The study population consisted of 1809 children aged between 0 and 19 years who had presented at an ED between 2002 and 2006 and were resident in a south-west metropolitan area of Perth traversed by major motorways. We used a 1:2 matched case-control study with gastroenteritis and upper limb injury as the control conditions. To estimate exposure to traffic emissions, we used 4 contrasting methods and 2 independently derived sources of traffic data (video-monitored traffic counts and those obtained from the state government road authority). The following estimates of traffic exposure were compared: (1) a point pattern method, (2) a distance-weighted traffic exposure method, (3) a simple distance method and (4) a road length method.</p> <p>Results</p> <p>Risk estimates were sensitive to socio-economic gradients and the type of exposure method that was applied. Unexpectedly, a range of apparent <it>protective </it>effects were observed for some exposure metrics. The kernel density measure demonstrated more than a 2-fold (OR 2.51, 95% CI 2.00 - 3.15) increased risk of asthma ED presentation for the high exposure group compared to the low exposure group.</p> <p>Conclusion</p> <p>We assessed exposure using traffic data from 2 independent sources and compared the results of 4 different exposure metric types. The results indicate that traffic congestion may be one of the most important aspects of traffic-related exposures, despite being overlooked in many studies on the exacerbation of asthma.</p

Quarkonium production via recombination

The contrast between model predictions for the transverse momentum spectra of J/Psi observed in Au-Au collisions at RHIC is extended to include effects of nuclear absorption. We find that the difference between initial production and recombination is enhanced in the most central collisions. Models utilizing a combination of these sources may eventually be able to place constraints on their relative magnitudes.Comment: Based on invited plenary talk at the 2nd International Conference on Hard and Electromagnetic Probes of High-Energy Nuclear Collisions, Asilomar, CA, June 9-16, 2006, to be published in Nucl. Phys.

Residential exposure to traffic emissions and adverse pregnancy outcomes

Motor vehicle traffic emissions are the single largest contributor to ambient air pollution in many developed countries and it has been suggested that these emissions can affect outcomes of pregnancy. An individual's exposure experience is greatly influenced by where they live as emission concentrations are much higher closer to roads. A systematic review was conducted using the MOOSE guidelines in order to synthesise studies published 1989-2009 which investigated pregnancy outcomes in relation to residential exposure to traffic emissions. Twelve studies met the inclusion criteria and were consequently reviewed. We identified exposure assessment methods and the scope of health endpoints that have been investigated. Gestational duration, intrauterine growth, mortality and pregnancy complications have been studied using simple distance, distance-weighted traffic density, annually averaged daily traffic counts, dispersion models and land-use regression models. Few studies investigated mortality and pregnancy complications and no study investigated the risk of congenital anomalies. The evidence to date suggests an adverse effect was consistently reported for gestational duration and less consistently reported yet plausible for intrauterine growth. However, the small number of studies, the possibility of publication bias and the limited research conducted on biological mechanisms precluded more formal statements on the existence of an effect. The ubiquity of motor vehicle traffic emissions, the biological vulnerability of the fetus, and the adverse associations detected among many of the twelve reviewed studies motivates a multidisciplinary collaborative effort toward further research on the topic

Fine Particulates, Preterm Birth, and Membrane Rupture in Rochester, NY

Background: It remains unclear whether fine particulate (PM2.5) exposure affects risk of preterm birth and prelabor rupture of membranes. Unmeasured, poorly measured, and undiscovered individual-level confounders might have introduced bias into past studies that relied on between-women comparisons. Methods: This was a longitudinal study of preterm birth and prelabor rupture of membranes in Rochester, NY, 2004–2012 (N = 3,264 women, N = 7,121 singleton births). We used conditional logistic regression to match pregnancies to the same woman and estimate the odds of each outcome associated with average PM2.5 concentrations during each trimester and whole pregnancy. Results: For preterm birth, adjusted odds ratios (95% confidence interval) for 1 µg/m3 increase in PM2.5 in the first trimester, second trimester, third trimester, and whole pregnancy were 1.11 (1.04, 1.18), 1.09 (1.02, 1.16), 1.06 (1.00, 1.13), and 1.17 (1.07, 1.28), respectively. For prelabor rupture of membranes, corresponding odds ratios were 1.00 (0.97, 1.04), 0.99 (0.96, 1.02), 0.99 (0.96, 1.03), and 0.99 (0.94, 1.04), respectively. Conclusion: Risk of preterm birth was greater for pregnancies with elevated PM2.5 exposure than other pregnancies to the same women at lower exposure. We did not observe an association between PM2.5 concentrations and prelabor rupture of membranes

Investigating the Impact of Maternal Residential Mobility on Identifying Critical Windows of Susceptibility to Ambient Air Pollution during Pregnancy

© 2018 The Author(s). Identifying periods of increased vulnerability to air pollution during pregnancy with respect to the development of adverse birth outcomes can improve understanding of possible mechanisms of disease development and provide guidelines for protection of the child. Exposure to air pollution during pregnancy is typically based on the mother's residence at delivery, potentially resulting in exposure misclassification and biasing the estimation of critical windows of pregnancy. In this study, we determined the impact of maternal residential mobility during pregnancy on defining weekly exposure to particulate matter less than or equal to 10 µm in aerodynamic diameter (PM 10) and estimating windows of susceptibility to term low birth weight. We utilized data sets from 4 Connecticut birth cohorts (1988-2008) that included information on all residential addresses between conception and delivery for each woman. We designed a simulation study to investigate the impact of increasing levels of mobility on identification of critical windows. Increased PM 10 exposure during pregnancy weeks 16-18 was associated with an increased probability of term low birth weight. Ignoring residential mobility when defining weekly exposure had only a minor impact on the identification of critical windows for PM 10 and term low birth weight in the data application and simulation study. Identification of critical pregnancy windows was robust to exposure misclassification caused by ignoring residential mobility in these Connecticut birth cohorts

The role of family planning counselling during maternal and child health services in postpartum modern contraceptive uptake in Ethiopia: A national longitudinal study

Family planning counselling can help improve the postpartum modern contraceptive uptake. However, studies in Ethiopia indicate inconsistent effects of integrated family planning counselling on postpartum modern contraceptive uptake. This study aimed to determine the extent of family planning counselling and its role in improving postpartum contraceptive uptake among women in Ethiopia. We used the Performance Monitoring for Action (PMA) Ethiopia panel survey data, a community-based prospective cohort study. Randomly selected pregnant women were recruited at the baseline interview and followed by six weeks and six months postpartum. A weighted generalised linear model fitted with a Poisson distribution and a log link function was used to estimate the adjusted relative risk (aRR) and 95% Confidence Interval (CI) of modern contraceptive uptake. The coverages of family planning counselling provision during ANC, prior to discharge and child immunisation were 20%, 27% and 23%, respectively. The modern contraceptive uptakes by six weeks and six months postpartum were 18% and 36%, respectively. Family planning counselling prior to discharge from the facility was associated with increased modern contraceptive uptake by six weeks (aRR 1.25; 95% CI 0.94, 1.65) and six months postpartum periods (aRR 1.07; 95% CI 0.90, 1.27). Moreover, women who received family planning counselling during child immunisation were 35% more likely to use modern contraceptives by six months postpartum (aRR 1.35;95% CI 1.12, 1.62). However, counselling during ANC visits was not associated with modern contraceptive uptake by either six weeks or six months postpartum. A significant proportion of women had missed the opportunity, and the postpartum modern contraceptive uptake was low. Despite these, family planning counselling prior to discharge from the facility and during child immunisation improved the postpartum modern contraceptive uptake. However, our finding revealed insufficient evidence that family planning counselling during ANC is associated with postpartum modern contraceptive uptake

Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother

Objective - To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. Design - Retrospective cohort study using conditional logistic regression (matching two intervals per mother so each mother acts as her own control) to model the incidence of adverse birth outcomes as a function of interpregnancy interval; additional unconditional logistic regression with adjustment for confounders enabled comparison with the unmatched design of previous studies. Setting - Perth, Western Australia, 1980-2010. Participants - 40 441 mothers who each delivered three liveborn singleton neonates. Main outcome measures - Preterm birth (<37 weeks), small for gestational age birth (<10th centile of birth weight by sex and gestational age), and low birth weight (<2500 g). Results - Within mother analysis of interpregnancy intervals indicated a much weaker effect of short intervals on the odds of preterm birth and low birth weight compared with estimates generated using a traditional between mother analysis. The traditional unmatched design estimated an adjusted odds ratio for an interpregnancy interval of 0-5 months (relative to the reference category of 18-23 months) of 1.41 (95% confidence interval 1.31 to 1.51) for preterm birth, 1.26 (1.15 to 1.37) for low birth weight, and 0.98 (0.92 to 1.06) for small for gestational age birth. In comparison, the matched design showed a much weaker effect of short interpregnancy interval on preterm birth (odds ratio 1.07, 0.86 to 1.34) and low birth weight (1.03, 0.79 to 1.34), and the effect for small for gestational age birth remained small (1.08, 0.87 to 1.34). Both the unmatched and matched models estimated a high odds of small for gestational age birth and low birth weight for long interpregnancy intervals (longer than 59 months), but the estimated effect of long interpregnancy intervals on the odds of preterm birth was much weaker in the matched model than in the unmatched model. Conclusion - This study questions the causal effect of short interpregnancy intervals on adverse birth outcomes and points to the possibility of unmeasured or inadequately specified maternal factors in previous studies

Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: A population-based cohort study

Objective - To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. Methods - Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982–2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery. Results - Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51–2.74), gestational diabetes (2.65, 2.08–3.57), pre-eclampsia (1.32, 1.04–1.87), post-partum hemorrhage (2.83, 1.92–4.67), cesarean delivery (2.62, 2.22–3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72–5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21–2.08), low birth weight (<2500 g: 1.51, 1.23–2.12), fetal growth restriction (3.27, 2.45–4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28–3.56), need for resuscitation (1.66, 1.27–2.19) or special care nursery admission (1.44, 1.13–1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors. Conclusion - Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention

Seaweed diversity associated with a Brazilian tropical rhodolith bed

This study describes the predominantly tropical, subtidal seaweed populations growing on rhodoliths between 4 and 18 m depth in the southern part of Espírito Santo State (Brazil). Qualitative and quantitative sampling revealed species-rich algal communities, comprising 167 species. Three species of rhodophytes represent new records for the Brazilian marine flora (Lithothamnion muelleri, Scinaia aborealis, and Mesophyllum engelhartii). Marked seasonal differences in fleshy algal species composition and abundance were related to seasonal instabilities caused by winter-storm disturbance over the rhodolith beds. In relation to depth, rhodolith density appears to be an important factor for the variation in the abundance of fleshy algae. The rhodolith community is composed of at least seven nongeniculate crustose coralline algal species. Rhodolith beds in southern Espírito Santo State, in an area of 150 km2, provide an important habitat for epibenthic communities, supporting 25% of the known macroalgal species richness along the Brazilian coast.Web of Scienc

Short interpregnancy interval and its predictors in Ethiopia: implications for policy and practice.

Introduction: interpregnancy interval (IPI) is the time elapsed between the birth of one live child and the conception of subsequent pregnancies. Several studies in Ethiopia indicated a high prevalence of a short interbirth interval - a proxy indicator of IPI. However, these studies were prone to selection bias as they did not include women who did not go on to have another pregnancy. Therefore, this study estimated the incidence of short IPI (< 24 months) and its risk factors among women who had at least one child in Ethiopia. Methods: we used a retrospective analysis of a cross-sectional study from the nationally representative Ethiopian Mini Demographic and Health Survey (EMDHS) conducted in 2019. The event was defined as the conception of the subsequent pregnancy within 24 months following the last child. A weighted Cox Proportional Hazard model was used to estimate the adjusted hazard ratios (aHR) and 95% confidence intervals (CIs). Results: the incidence of short IPI was 6%. Rural residence, being young age, low educational attainment, having the last child died and having female last birth were the risk factors for short IPI. However, having higher parity, attending Antenatal Care (ANC) visits, being delivered at a health facility, and receiving Postnatal Care (PNC) visits were the protective factors for short IPI. Conclusion: the incidence of short IPI in Ethiopia was considerable. Sociodemographic and health service-related factors determine the short IPI. Hence, considering the immediate and long-term health and socioeconomic consequences of short IPI, the Ethiopian government should implement holistic and multisectoral interventions