Using Nature and Outdoor Activity to Improve Children's Health McCurdy, Leyla E., MPhil; Winterbottom, Kate E., MPH; Mehta, Suril S., MPH ...
Current problems in pediatric and adolescent health care,
05/2010, Letnik:
40, Številka:
5
Journal Article
Recenzirano
Childhood obesity affects 17% or 12.5 million of America's children, contributing to the rise in children's health disparities. Type 2 diabetes, asthma, vitamin D deficiency, and ...attention-deficit/hyperactivity disorder have also increased over the past few decades. A shift toward a sedentary lifestyle is a major contributor to the decline in children's health. Children spend more time indoors using electronic media and less time engaged in outdoor unstructured play. This article reviews the current evidence of the mental and physical health benefits associated with unstructured, outdoor activities and time spent in a natural environment such as a park or other recreational area. Pediatric health care providers should recommend outdoor activities for children and refer families to safe and easily accessible outdoor areas. Pediatric health care providers can incorporate this simple, lifestyle-based intervention into anticipatory guidance.
Idiopathic pulmonary fibrosis (IPF), a progressive disease with an unknown pathogenesis, may be due in part to an abnormal response to injurious stimuli by alveolar epithelial cells. Air pollution ...and particulate inhalation of matter evoke a wide variety of pulmonary and systemic inflammatory diseases. We therefore hypothesized that increased average ambient particulate matter (PM) concentrations would be associated with an accelerated rate of decline in FVC in IPF.
We identified a cohort of subjects seen at a single university referral center from 2007 to 2013. Average concentrations of particulate matter < 10 and < 2.5 μg/m3 (PM10 and PM2.5, respectively) were assigned to each patient based on geocoded residential addresses. A linear multivariable mixed-effects model determined the association between the rate of decline in FVC and average PM concentration, controlling for baseline FVC at first measurement and other covariates.
One hundred thirty-five subjects were included in the final analysis after exclusion of subjects missing repeated spirometry measurements and those for whom exposure data were not available. There was a significant association between PM10 levels and the rate of decline in FVC during the study period, with each μg/m3 increase in PM10 corresponding with an additional 46 cc/y decline in FVC (P = .008).
Ambient air pollution, as measured by average PM10 concentration, is associated with an increase in the rate of decline of FVC in IPF, suggesting a potential mechanistic role for air pollution in the progression of disease.
Cranberry juice cocktail containing A-type proanthocyanidins exhibited bacterial anti-adhesion activity in human urine when compared to foods containing B-type proanthocyanidins. Proanthocyanidin ...linkage type and differences among general structural features may be contributing to anti-adhesion activity.
Clinical, epidemiological and mechanistic studies support the role of cranberry (
Vaccinium macrocarpon Ait.) in maintaining urinary tract health. Cranberry proanthocyanidins contain A-type linkages and have been associated with preventing adhesion of P-fimbriated uropathogenic
Escherichia coli to uroepithelial cells. It is not known if the presence of the A-type linkage is a prerequisite for anti-adhesion activity. Other commercial sources of proanthocyanidins with all B-type linkages have not previously been screened for this activity. The goals of this study were to compare the in vitro anti-adhesion activity of A-linked proanthocyanidins from cranberry juice cocktail with the anti-adhesion activities of B-linked proanthocyanidins from commercial grape and apple juices, green tea and dark chocolate, and determine if anti-adhesion activity is detectable in human urine following consumption of single servings of each commercial food product. Structural heterogeneity and presence of the A-type linkage in cranberry proanthocyanidins was confirmed utilizing MALDI-TOF/MS and DI/ESI MS, as was the presence of all B-type linkages in the proanthocyanidins from the other commercial products. The isolated A-type proanthocyanidins from cranberry juice cocktail elicited in vitro anti-adhesion activity at 60
μg/ml, the B-type proanthocyanidins from grape exhibited minor activity at 1200
μg/ml, while other B-type proanthocyanidins were not active. Anti-adhesion activity in human urine was detected following cranberry juice cocktail consumption, but not after consumption of the non-cranberry food products. Results suggest that presence of the A-type linkage in cranberry proanthocyanidins may enhance both in vitro and urinary bacterial anti-adhesion activities and aid in maintaining urinary tract health.
Endovascular aneurysm sealing (EVAS) with the Nellix stent graft system is a novel concept in the management of abdominal aortic aneurysm (AAA) that aims to reduce the prevalence of all endoleaks ...following endovascular repair. There are few data describing the longer-term durability of this approach. The aim was to report the longer-term outcomes following EVAS in a single centre.
This is a retrospective review of all patients that underwent Nellix at Cambridge University Hospitals Foundation Trust. Factors that are described as device failure include secondary sac rupture, graft explantation, further surgical procedures for Type 1 endoleak, or major migration of the stent grafts with pressurisation of the aortic sac.
A total of 161 patients have been treated with Nellix. The indications included primary AAA (n = 115), ruptured AAA (n = 4), salvage of other aortic grafts (n = 18), primary iliac aneurysm (n = 6), and chimney EVAS (ChEVAS) for pararenal AAA (n = 18). In total there have been 42 graft failures in patients treated with EVAS for primary AAA. The 4 year freedom from graft failure was 42% in patients treated for primary AAA. Failures mostly occurred more than 2 years post-Nellix implant. There were eight secondary sac ruptures (incidence 2.4 per 100 person years) and there have been 14 graft explants.
Failure of aneurysm sealing following treatment with Nellix has been more common than anticipated and can cause aortic rupture. Post-operative surveillance of Nellix stent grafts is crucial to identify features of failure.
Summary
Pulse oximetry is used widely to titrate oxygen therapy and for triage in patients who are critically ill. However, there are concerns regarding the accuracy of pulse oximetry in patients ...with COVID‐19 pneumonitis and in patients who have a greater degree of skin pigmentation. We aimed to determine the impact of patient ethnicity on the accuracy of peripheral pulse oximetry in patients who were critically ill with COVID‐19 pneumonitis by conducting a retrospective observational study comparing paired measurements of arterial oxygen saturation measured by co‐oximetry on arterial blood gas analysis (SaO2) and the corresponding peripheral oxygenation saturation measured by pulse oximetry (SpO2). Bias was calculated as the mean difference between SaO2 and SpO2 measurements and limits of agreement were calculated as bias ±1.96 SD. Data from 194 patients (135 White ethnic origin, 34 Asian ethnic origin, 19 Black ethnic origin and 6 other ethnic origin) were analysed consisting of 6216 paired SaO2 and SpO2 measurements. Bias (limits of agreement) between SaO2 and SpO2 measurements was 0.05% (−2.21–2.30). Patient ethnicity did not alter this to a clinically significant degree: 0.28% (1.79–2.35), −0.33% (−2.47–2.35) and −0.75% (−3.47–1.97) for patients of White, Asian and Black ethnic origin, respectively. In patients with COVID‐19 pneumonitis, SpO2 measurements showed a level of agreement with SaO2 values that was in line with previous work, and this was not affected by patient ethnicity.
Aim To evaluate whether virtual unenhanced (VU) computed tomography (CT) images generated of the aorta were of sufficient quality to replace the conventional unenhanced (CU) images. Materials and ...methods Forty-nine patients undergoing examination of the thoracic or abdominal aorta were examined using a dual-energy protocol. VU images were generated from the arterial phase images and compared to the CU images. Objective analysis was performed by drawing paired regions of interest (ROIs) within the thoracic and abdominal aorta and measuring the radiodensity in Hounsfield units attenuation within the ROIs. Subjective analysis was performed by two experienced readers evaluating the VU images in terms of noise, quality, calcium loss, and overall acceptability. Results The attenuation was significantly higher in the VU images compared to the CU images within the thoracic aorta ( p < 0.01) but not within the abdominal aorta ( p = 0.15). Overall the VU images of the abdominal aorta were deemed acceptable as replacements for the CU images in 93% of cases. For the thoracic aorta, the VU images were deemed acceptable in only 12% of cases, primarily due to pulsation artefact. Conclusion VU images of the abdominal aorta are acceptable as replacements for the CU images in the vast majority of cases; however, they are not suitable as replacements for the CU images of the thoracic aorta.
Forest and tree cover is declining at alarming rates throughout the developing world. As a result, essential sources of food, fuel, shelter, fodder, medicines, and many other products are ...disappearing, and the soil and water base for food production is being degraded. Solutions are urgently needed as populations and human needs continue to grow. "Agroforestry," or the deliberate association of trees and shrubs with crops, livestock or other factors of agricultural production, holds great promise for contributing to sustainable landuse systems. Agroforestry approaches are appropriate to the needs of low-resource farmers and the physical and socioeconomic constraints they face. However, the potential contribution of agroforestry can be realized only if farmers and local communities are fully involved in its development and application.
Non-catalytic esterification of Free Fatty Acids (FFA) with supercritical methanol was studied under reaction conditions of (250–320
°C) at 10
MPa. A detailed experimental programme was implemented ...to investigate the influence of temperature, stirring rate and the molar ratio of methanol to FFA in the feed in a batch-type reaction vessel. The esterification products of FFA with supercritical methanol are Fatty Acids Methyl Esters (FAME; biodiesel) and water. The yield of FAME was found to increase with an increase in temperature, and with an increase in the molar ratio of methanol to FFA. At >850
rpm the yield of FAME was not affected by stirring rate. The rate constants and energy of activation have been numerically evaluated by solving an ordinary differential equation that describes the reaction kinetics. The proposed kinetic model shows a reversible second order reaction and represents all the experimental data satisfactorily, providing deeper insight into the kinetics of the reaction.
We analysed data on Indo-Pacific coral reef taxa to test four mechanisms proposed for the origins of the biodiversity centre in the East Indies Triangle: (1) the centre of origin hypothesis, (2) the ...centre of accumulation hypothesis, (3) the centre of overlap hypothesis, and (4) the bioaccumulation hypothesis. The Indian and western Pacific oceans. The data set consisted of eight clades of fishes, four of corals and one of molluscs, consisting of a total of 95 species, with 72 informative nodes, in 29 areas. We used phylogenetic analysis for comparing trees (PACT) to reconstruct reticulate area relationships. An analysis using PACT produced very little congruence between area relationships among the histories of the taxa examined. Only two sets of two taxa each showed substantial congruence; several other taxa showed partial congruence. Despite numerous 'explanatory' claims for the incredible biodiversity of the marine macrofauna of the East Indies Triangle, the patterns obtained here did not accord with any of the hypotheses proposed. It is possible that, with the addition of more taxa, additional patterns would emerge. Much more systematic work within the East Indies is required to resolve this problem.
Background
Patients are satisfied with their kidney care but want more support in making dialysis choices. Predialysis leaflets vary across services, with few being sufficient to enable patients’ ...informed decision making. We describe the acceptability of a patient decision aid and feasibility of evaluating its effectiveness within usual predialysis practice.
Methods
Prospective non-randomized comparison design, Usual Care or Usual Care Plus Yorkshire Dialysis Decision Aid Booklet (+YoDDA), in 6 referral centers (Yorkshire-Humber, UK) for patients with sustained deterioration of kidney function. Consenting (C) patients completed questionnaires after predialysis consultation (T1), and 6 weeks later (T2). Measures assessed YoDDA's utility to support patients’ decisions and integration within usual care.
Results
Usual Care (n = 105) and +YoDDA (n = 84) participant characteristics were similar: male (62%), white (94%), age (mean = 62.6; standard deviation SD 14.4), kidney disease severity (glomerular filtration rate eGFR mean = 14.7; SD 3.7); decisional conflict was < 25; choice-preference for home versus hospital dialysis approximately 50:50. Patients valued receiving YoDDA, reading it on their own (96%), and sharing it with family (72%). The +YoDDA participants had higher scores for understanding kidney disease, reasoning about options, feeling in control, sharing their decision with family. Study engagement varied by center (estimated range 14 – 49%; mean 45%); participants varied in completion of decision quality measures.
Conclusions
Receiving YoDDA as part of predialysis education was valued and useful to patients with worsening kidney disease. Integrating YoDDA actively within predialysis programs will meet clinical guidelines and patient need to support dialysis decision making in the context of patients’ lifestyle.
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