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Skinner M.P.,University of Queensland | Brewer T.D.,James Cook University | Johnstone R.,University of Queensland | Fleming L.E.,European Center for Environment and Human Health | And 2 more authors.
PLoS Neglected Tropical Diseases | Year: 2011

Background: Ciguatera is a type of fish poisoning that occurs throughout the tropics, particularly in vulnerable island communities such as the developing Pacific Island Countries and Territories (PICTs). After consuming ciguatoxin-contaminated fish, people report a range of acute neurologic, gastrointestinal, and cardiac symptoms, with some experiencing chronic neurologic symptoms lasting weeks to months. Unfortunately, the true extent of illness and its impact on human communities and ecosystem health are still poorly understood. Methods: A questionnaire was emailed to the Health and Fisheries Authorities of the PICTs to quantify the extent of ciguatera. The data were analyzed using t-test, incidence rate ratios, ranked correlation, and regression analysis. Results: There were 39,677 reported cases from 17 PICTs, with a mean annual incidence of 194 cases per 100,000 people across the region from 1998-2008 compared to the reported annual incidence of 104/100,000 from 1973-1983. There has been a 60% increase in the annual incidence of ciguatera between the two time periods based on PICTs that reported for both time periods. Taking into account under-reporting, in the last 35 years an estimated 500,000 Pacific islanders might have suffered from ciguatera. Conclusions: This level of incidence exceeds prior ciguatera estimates locally and globally, and raises the status of ciguatera to an acute and chronic illness with major public health significance. To address this significant public health problem, which is expected to increase in parallel with environmental change, well-funded multidisciplinary research teams are needed to translate research advances into practical management solutions. © 2011 Skinner et al.


Southward E.F.,University of Bristol | Page A.S.,University of Bristol | Wheeler B.W.,European Center for Environment and Human Health | Cooper A.R.,University of Bristol
American Journal of Preventive Medicine | Year: 2012

Background: Active travel is a possible method to increase physical activity in children, but the precise contribution of walking to school to daily physical activity is unclear. Purpose: To combine accelerometer and GPS data to quantify moderate-to-vigorous physical activity (MVPA) on the walk to and from school in relation to overall daily levels. Methods: Participants were 141 children aged 11-12 years from the PEACH Project (Personal and Environmental Associated with Children's Health) in Bristol, England, measured between 2008 and 2009. Eighty-four children met the inclusion criteria and were included in the final analysis. Accelerometers measured physical activity, GPS receivers recorded location, and mode of travel was self-reported. Data were analyzed between April and October 2011. Combined accelerometer and GPS data were mapped in a GIS. Minutes of MVPA were compared for school journeys taking place between 8:00am and 9:00am and between 3:00pm and 5:00pm and in relation to whole-day levels. Results: Physical activity levels during journeys to and from school were highly similar, and contributed 22.2 minutes (33.7%) of total daily MVPA. In addition, MVPA on the journey did not differ between boys and girls, but because girls have lower levels of daily physical activity than boys, the journey contributed a greater proportion of their daily MVPA (35.6% vs 31.3%). Conclusions: The journey to and from school is a significant contributor to MVPA in children aged 11-12 years. Combining GPS and accelerometer data within a GIS is a useful approach to quantifying specific journeys. © 2012 American Journal of Preventive Medicine.


Clark J.D.,University of Miami | Serdar B.,Aurora University | Lee D.J.,University of Miami | Arheart K.,University of Miami | And 3 more authors.
Environmental Research | Year: 2012

Polycyclic aromatic hydrocarbons (PAHs) are environmental and occupational carcinogens produced by the incomplete combustion of organic materials, such as coal and petroleum product combustion, tobacco smoking, and food cooking, that may be significant contributors to the burden of cardiovascular disease in human populations. The purpose of this study was to investigate associations between ten monohydroxy urinary metabolites of four PAHs and three serum biomarkers of cardiovascular disease (fibrinogen, homocysteine, and white blood cell count). Using data on 3219 participants aged 20 years and older from the National Health and Nutrition Examination Survey (NHANES) 2001-2004 dataset, the associations between PAH metabolites and serum inflammatory markers were analyzed using the Spearman correlations and multiple linear regression modeling. The PAH metabolites of naphthalene, fluorene, phenanthrene, and pyrene each showed both positive and negative correlations with homocysteine, fibrinogen, and white blood cell count (correlation coefficient range: -0.077-0.143) in nonsmoking participants. Using multiple linear regression models adjusted for age, gender, race/ethnicity, and body mass index, estimates of weighted geometric means of inflammatory marker levels were not significantly different between high and low levels (75th vs. 25th percentiles) for all PAH metabolites in nonsmoking subjects. The results of this study do not provide evidence for a relationship between PAH exposure (as measured by urinary levels of PAH metabolites) and serum biomarkers of cardiovascular disease after controlling for tobacco use. © 2012 Elsevier Inc.


Nunn K.,Westmead Childrens Hospital | Frampton I.,Gt. Ormond St Hospital | Frampton I.,University of Oslo | Frampton I.,European Center for Environment and Human Health | And 2 more authors.
Medical Hypotheses | Year: 2012

Anorexia nervosa manifests a wide range of features which cannot fully be explained on the basis of socio-cultural pressures to be thin, nor by starvation, nor dehydration. Evidence is emerging of a significant neurobiological contribution to its aetiology. However there has to date been no explanation for its pathogenesis that integrates the previously identified genetic, neurobiological and socio-cultural contributing factors. In this paper we propose an empirically-based hypothesis that genetically determined noradrenergic dysregulation, interacting with epigenetic factors, leads to high levels of anxiety, impaired neuroplasticity and regional cerebral hypoperfusion. These, in combination, lead to insula dysfunction. The resulting impairment in insula homuncular representation explains the pathognomonic body image distortion. This distortion, combined with high levels of body-focused anxiety, gives rise to intense dieting, noradrenergic precursor depletion, and initial reduction in anxiety. The subsequent rebound exacerbation of anxiety leads to a vicious cycle of maintenance. Novel treatment implications based on this hypothesis are briefly considered. © 2012 Elsevier Ltd.


Moran R.,European Center for Environment and Human Health | Davidson P.,University of Southampton
International Journal of Technology Assessment in Health Care | Year: 2011

Objectives: This study comprises a review of public involvement strategies across the five stages of research management in the UK's HTA program at the end of a 10-year period. These five stages are: identification of topics; prioritization of these topics as researchable questions; commissioning of research; monitoring of projects throughout their implementation; and publication and dissemination of findings. Methods: Internal HTA documentation was analyzed alongside narrative analysis of semi-structured interviews of program staff, and a rapid review of published literature. Results: Public involvement strategies have developed with the growth of the HTA program but were spread unevenly across the five stages of research management. Public involvement was present in identification, strongest in prioritization, present in commissioning but minimal in monitoring and absent in publication and dissemination. Conclusions: The HTA program has developed public involvement strategies but mainly in prioritization. Further research is required to ascertain where public involvement can be most appropriately used and to evaluate its impact. © Cambridge University Press 2011.

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