Impact of primary health care on childhood and mortality in rural Ghana: the Gomoa experience

A CAJM article on the impact of primary healthcare activities in Ghana.The impact of a combination of PHC intervention activities on child survival, growth, morbidity and mortality was assessed in three selected rural communities (Gomoa Fetteh, Gomoa Onyadze/Otsew Jukwa and Gomoa Mprumem) in the Central Region of Ghana from 1987 to 1990. EPI, provision of basic essential drugs and supplies for the treatment of common childhood diseases, treatment of the sick child, growth monitoring, health education, provision of antenatal services, family planning, training and supervision of Community Health Workers, disease surveillance and special studies were the major PHC strategies used to improve the health of the child and the pregnant woman in the three communities

Small-for-Gestational Age Prevalence Risk Factors in Central Appalachian States with Mountain-top Mining.

OBJECTIVES: To identify risk factors for small-for-gestational age (SGA) for counties in central Appalachian states (Kentucky (KY), Tennessee (TN), Virginia (VA), and West Virginia (WV)) with varied coal mining activities. MATERIAL AND METHODS: Live birth certificate files (1990-2002) were used for obtaining SGA prevalence rates for mothers based on the coal mining activities of their counties of residence, mountain-top mining (MTM) activities, underground mining activities but no mountain-top mining activity (non-MTM), or having no mining activities (non-mining). Co-variable information, including maternal tobacco use, was also obtained from the live birth certificate. Adjusted odds ratios were obtained using multivariable logistic regression comparing SGA prevalence rates for counties with coal mining activities to those without coal mining activities and comparing SGA prevalence rates for counties with coal mining activities for those with and without mountain-top mining activities. Comparisons were also made among those who had reported tobacco use and those who had not. RESULTS: Both tobacco use prevalence and SGA prevalence were significantly greater for mining counties than for non-mining counties and for MTM counties than for non-MTM counties. Adjustment for tobacco use alone explained 50% of the increased SGA risk for mining counties and 75% of the risk for MTM counties, including demographic pre-natal care co-variables that explained 75% of the increased SGA risk for mining counties and 100% of the risk for MTM. The increased risk of SGA was limited to the third trimester births among tobacco users and independent of the mining activities of their counties of residence. CONCLUSIONS: This study demonstrates that the increased prevalence of SGA among residents of counties with mining activity was primarily explained by the differences in maternal tobacco use prevalence, an effect that itself was gestational-age dependent. Self-reported tobacco use marked the population at the increased risk for SGA in central Appalachian states. Int J Occup Med Environ Health 2018;31(1):11-23

Arsenic in Drinking Water and Lung Cancer Mortality in the United States: An Analysis Based on US Counties and 30 Years of Observation (1950-1979).

Background. To examine whether the US EPA (2010) lung cancer risk estimate derived from the high arsenic exposures (10-934 µg/L) in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3-59 µg/L). Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes) were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. The unit risk estimates were nonpositive and not significantly different from zero, and the maximum (95% UCL) unit risk estimates for lung cancer were lower than those in US EPA (2010). Conclusions. These data do not demonstrate an increased risk of lung cancer associated with median drinking water arsenic levels in the range of 3-59 µg/L. The upper-bound estimates of the risks are lower than the risks predicted from the SW Taiwan data and do not support those predictions. These results are consistent with a recent metaregression that indicated no increased lung cancer risk for arsenic exposures below 100-150 µg/L

Farming Practices of Vegetables: a Comparative Study in Four Regions of East Java and Bali Provinces

Agronomic and ecological aspects play important roles in vegetable production, because the aspects will be used for determining suitable interventions. This study aims to provide current farmers\u27 practices of vegetable production, particularly for agronomic and ecological aspects of chilli and tomato in four regions of East Java and Bali. This study uses of analytical tool of descriptive approach by comparing and contrasting each production practices across regions. Data were compiled from a field survey of 360 farmers during 2013-2014. Results of analysis were presented in graphical and tabular forms. Farmers mostly selected hybrid varieties of vegetables because of economic reasons, such as high yield, good appearance and high number of fruits. Anthracnose and late blight were perceived as the most important disease in chilli and tomato respectively. Farmers controlled pests and diseases using pesticides. In general, farmers perceived that irrigation was one of limiting factors of vegetable farming. Poor drainage was one of the crucial issues in Bali. Farmers mostly sold vegetable once harvested. Post-harvest handling was still traditional, where farmers still less pay attention on post-harvest, even though they observed the economic advantage of post-harvest. Based on the existing practices, a special extension on vegetable production needs to be formulated appropriately, based on the specific characteristics of each region

Wearable sensing and mining of the informativeness of older adults : physiological, behavioral, and cognitive responses to detect demanding environmental conditions

Due to the decline in functional capability, older adults are more likely to encounter excessively demanding environmental conditions (that result in stress and/or mobility limitation) than the average person. Current efforts to detect such environmental conditions are inefficient and are not person-centered. This study presents a more efficient and person-centered approach that involves using wearable sensors to collect continuous bodily responses (i.e., electroencephalography, photoplethysmography, electrodermal activity, and gait) and location data from older adults to detect demanding environmental conditions. Computationally, this study developed a Random Forest algorithm—considering the informativeness of the bodily response—and a hot spot analysis-based approach to identify environmental locations with high demand. The approach was tested on data collected from 10 older adults during an outdoor environmental walk. The findings demonstrate that the proposed approach can detect demanding environmental conditions that are likely to result in stress and/or limited mobility for older adults

Transforming tribal communities in Telangana, India, into strategic business enterprises — a paradigm for inclusive growth

Global food systems are failing both people and the planet due to overarching interconnected challenges, including climate change, natural resource depletion, biodiversity loss, malnutrition, food insecurity, gender inequality and preventable ill-health, all of which are exacerbated by the fragmentation of food systems and policy incoherence. Here, we present innovative interventions that have addressed critical bottlenecks in the transformation of food systems, with a case study on linking entrepreneurship with agriculture and nutrition/health via a convergence model in a select tribal locale of India

Arsenic in Drinking Water and Lung Cancer Mortality in the United States: An Analysis Based on US Counties and 30 Years of Observation (1950–1979)

Background. To examine whether the US EPA (2010) lung cancer risk estimate derived from the high arsenic exposures (10–934 µg/L) in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3–59 µg/L). Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes) were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. The unit risk estimates were nonpositive and not significantly different from zero, and the maximum (95% UCL) unit risk estimates for lung cancer were lower than those in US EPA (2010). Conclusions. These data do not demonstrate an increased risk of lung cancer associated with median drinking water arsenic levels in the range of 3–59 µg/L. The upper-bound estimates of the risks are lower than the risks predicted from the SW Taiwan data and do not support those predictions. These results are consistent with a recent metaregression that indicated no increased lung cancer risk for arsenic exposures below 100–150 µg/L