Climate change and health in Earth's future

Threats to health from climate change are increasingly recognized, yet little research into the effects upon health systems is published. However, additional demands on health systems are increasingly documented. Pathways include direct weather impacts, such as amplified heat stress, and altered ecological relationships, including alterations to the distribution and activity of pathogens and vectors. The greatest driver of demand on future health systems from climate change may be the alterations to socioeconomic systems; however, these “tertiary effects” have received less attention in the health literature. Increasing demands on health systems from climate change will impede health system capacity. Changing weather patterns and sea-level rise will reduce food production in many developing countries, thus fostering undernutrition and concomitant disease susceptibility. Associated poverty will impede people’s ability to access and support health systems. Climate change will increase migration, potentially exposing migrants to endemic diseases for which they have limited resistance, transporting diseases and fostering conditions conducive to disease transmission. Specific predictions of timing and locations of migration remain elusive, hampering planning and misaligning needs and infrastructure. Food shortages, migration, falling economic activity, and failing government legitimacy following climate change are also “risk multipliers” for conflict. Injuries to combatants, undernutrition, and increased infectious disease will result. Modern conflict often sees health personnel and infrastructure deliberately targeted and disease surveillance and eradication programs obstructed. Climate change will substantially impede economic growth, reducing health system funding and limiting health system adaptation. Modern medical care may be snatched away from millions who recently obtained it

Parents' and clinicians' views of an interactive booklet about respiratory tract infections in children: a qualitative process evaluation of the EQUIP randomised controlled trial

Background: ‘When should I worry?’ is an interactive booklet for parents of children presenting with respiratory tract infections (RTIs) in primary care and associated training for clinicians. A randomised controlled trial (the EQUIP study) demonstrated that this intervention reduced antibiotic prescribing and future consulting intentions. The aims of this qualitative process evaluation were to understand how acceptable the intervention was to clinicians and parents, how it was implemented, the mechanisms for any observed effects, and contextual factors that could have influenced its effects.<p></p> Methods: Semi-structured interviews were conducted with 20 parents and 13 clinicians who participated in the trial. Interviews were audio-recorded and transcribed verbatim. Data were analysed using a framework approach, which involved five stages; familiarisation, development of a thematic framework, indexing, charting, and interpretation.<p></p> Results: Most parents and clinicians reported that the ‘When should I worry’ interactive booklet (and online training for clinicians) was easy to use and valuable. Information on recognising signs of serious illness and the usual duration of illness were most valued. The interactive use of the booklet during consultations was considered to be important, but this did not always happen. Clinicians reported lack of time, lack of familiarity with using the booklet, and difficulty in modifying their treatment plan/style of consultation as barriers to use. Increased knowledge and confidence amongst clinicians and patients were seen as key components that contributed to the reductions in antibiotic prescribing and intention to consult seen in the trial. This was particularly pertinent in a context where decisions about the safe and appropriate management of childhood RTIs were viewed as complex and parents reported frequently receiving inconsistent messages. Conclusions: The ‘When should I worry’ booklet, which is effective in reducing antibiotic prescribing, has high acceptability for clinicians and parents, helps address gaps in knowledge, increases confidence, and provides a consistent message. However, it is not always implemented as intended. Plans for wider implementation of the intervention in health care settings would need to address clinician-related barriers to implementation

“All about communication" - a perspective on our public involvement practices in the Networked Data Lab in Grampian

Peer reviewe

The Effects of Shift Work on the Worker

There are approximately 15.5 million shift workers in the United States who work outside the standard diurnal (daytime) working hours of 7 am to 6 pm. As technology, globalization of industries, and the demands of a 24-hour society continue to escalate, so will the need for more workers to staff the related occupations around the clock. The types of occupations that include a large workforce percentage of shift workers are those that provide a 24/7 continuum of services such as healthcare workers, long-distance truck drivers, airline pilots, as well as a variety of service industry employees who produce goods and services on a continuous basis. Working non-diurnal hours on a regular basis, more commonly known as shift work, has been linked to many negative health consequences, including cardiovascular disease, gastrointestinal disturbances, sleep disruptions, and excessive fatigue. The reasons for these outcomes and an actual causal relationship between shift work and health effects have been widely debated among researchers. The disruptions to the body's natural biorhythms, or circadian rhythms, caused by shift work seem to be a common thread throughout much of the research in the field. This paper explores these negative health sequelae currently reported as possibly being caused by the body's inability to adapt to shift work hours. An explanation of the physical manifestations of these effects will be given. The role of the occupational and environmental health nurse as a consultant and educator will be discussed to minimize the negative effects of shift work and provide realistic solutions in assisting workers to cope with these varying work schedules.Master of Public Healt

Search for nearby Earth analogs I. 15 planet candidates found in PFS data

30 pages, 20 figures, 3 tables, accepted for publication in ApJSThe radial velocity (RV) method plays a major role in the discovery of nearby exoplanets. To efficiently find planet candidates from the data obtained in high-precision RV surveys, we apply a signal diagnostic framework to detect RV signals that are statistically significant, consistent in time, robust in the choice of noise models, and do not correlated with stellar activity. Based on the application of this approach to the survey data of the Planet Finder Spectrograph, we report 15 planet candidates located in 14 stellar systems. We find that the orbits of the planet candidates around HD 210193, 103949, 8326, and 71135 are consistent with temperate zones around these stars (where liquid water could exist on the surface). With periods of 7.76 and 15.14 days, respectively, the planet candidates around star HIP 54373 form a 1:2 resonance system. These discoveries demonstrate the feasibility of automated detection of exoplanets from large RV surveys, which may provide a complete sample of nearby Earth analogs.Peer reviewedFinal Accepted Versio

Time to Regenerate: Ecosystems and Health Promotion

Butler and Friel call upon the health promotion community to strongly reengage with environmental and ecological issues

Mechanism of Acid Catalysis in the Cyclisation of 5-Aminolevulinic Acid and Acetylacetone to 3-Acetyl-4-(2-ca rboxyethyl) -2-methylpyrrole

Under acid conditions 5-aminolevulinic acid reacts with acetylacetone to give 3-acetyl-4-(2-carboxyethyl)-2-methylpyrrole (1 ). There is also formation of a small amount of the Fischer-Fink product (2). Use of 13C and 15N NMR spectroscopy showed that the first condensation product to accumulate is the enaminoketone (5). The trifluoro analogue of 5 can be isolated and its cyclisation to 8 was monitored. There is a substantial spontaneous reaction and the acid-catalysed process occurs by specific acid catalysis. 5-Aminolevulinic acid (5-ALA) condenses with acetylacetone (pentane-2,4-dione) in an acid-catalysed reaction to give a mixture of two products: 3-acetyl-4-(2-carboxyethyl)-2-methylpyrrole 1, the Knorr product, and 2-(3-~arboxypropionyl)-3,5-dimethylpyrrole 2, the Fischer-Fink product (Scheme 1). The former is the dominant product, forming 95% of the total. We are interested in this reaction as it is a nonenzymic model for the enzyme-catalysed condensation of two molecules of 5-ALA to form prophobilinogen 3, a buildng block en route to a number of important natural pigments. The reaction shown in Scheme 1 involves several bond-breaking and bond-making processes. As the reaction occurs only under acid conditions, acid catalysis must play an important role in effecting reaction but not all the steps need be acid-catalysed; some could occur spontaneously once a certain reaction intermediate has been formed. In a previous publication we proposed a sequence of steps in the formation of 1 and 2 and now report an attempt to identify the catalysed steps within that sequence. The Fischer-Fink product 2 is formed in such small quantities that we have made no attempt to delineate the mechanism of its formation. Factors influencing the relative amounts of Knorr and Fischer-Fink products have been discussed previously. Results and Discussion It is necessary, firstly, to establish the tautomeric form ALAOHCl (5% enriched) and pentane-2,4-dione in an acetate buffer containing deuterioacetic acid of pH 6.45 was monitored over 6 h and a spectrum recorded every 20 min. An examination of the spectra revealed that, apart from the reactant peaks which diminished in intensity with time and the product peaks which increased in intensity with time, there was a cluster of peaks which grew to a maximum and gradually diminished to zero as the reaction proceeded. The transient peaks within the cluster were assigned to a single intermediate species since they all appear to grow to a maximum and diminish at the same time. Most of the peaks in the cluster are similar to those in the reactants, as would be expected, but there is one peak at 6 167.1 which lies in the 13C NMR shift range for imines and enamine~.~ This observation, however, does not allow us to distinguish between the three possibilities 4-6. The carbon atom marked with an asterisk, which is the location of the label, would have a similar shift in all three. The appearance of a signal with this shift, however, does indicate that it is the unsaturated intermediate, rather than the previously formed aminoalcohol, which accumulates, i.e. dehydration of the aminoalcohol is fast. A more detailed examination of the spectral changes occurring during reaction yielded little extra information. They were recorded over only 6 h, although the reaction was incomplete at this stage, as the products saturate the reaction mixture and come out of solution. As a result, uniform shimming could not be attained and no significant change

Relaxation oscillations suppression and undamping in a hybrid photonic crystal laser

As demand towards cloud-based services and high-performance computations grows, it imposes requirements on data center performance, and efficiency. Taking advantage of the mature CMOS process technology, and the fact that silicon is the basic material of electronics industry, silicon photonics makes possible production photonic integrated circuits that satisfy these requirements. Here we explore the short-cavity hybrid laser consisting of a III-V amplifier integrated with a silicon photonic crystal (PhC) cavity reflector by so-called butt-coupling approach. The laser possesses great stability characteristics meeting the criteria for data center interconnect applications. The PhC reflector having a Q-factor of 104 at the lasing wavelength 1535 nm can be considered as a narrow-bandwidth filter. The laser demonstrates single mode and eventless operation without any dynamics on the background, and smooth radiofrequency spectrum without evidence of relaxation oscillation frequency. The latter fact is beneficial for many applications, and indicates extremely high damping in PhC laser, where the photon cavity lifetime is greatly improved by the high-Q PhC cavity reflector. We confirm our experimental observations by theory based on delay differential equation model for a single-section semiconductor laser. We reveal the effective damping of the laser, when the detuning between the filter peak and the laser cavity mode is small, and the imaginary parts of the model eigenvalues equal zero. It is possible to undamp the relaxation oscillations forcing self-Q-switched operation in the laser owing to the cumulative action of the alpha-factor and the narrow filter. In conclusion, we experimentally and theoretically demonstrated that relaxation oscillations can be suppressed in the short-cavity semiconductor laser with a narrow intracavity frequency filter. Additionally, on the basis of our analysis we expect the undamping of relaxation oscillations, and self-pulsations when the cavity mode is detuned from the filter peak frequency. The results might be useful for applications in data communications.Publisher PD