Seroprevalence of hepatitis E antibodies in a population of recyclable waste pickers in Brazil

BackgroundHepatitis E virus (HEV) infection represents an important cause of acute viral hepatitis. Selective waste collection is a widespread activity carried out by the urban poor, and recyclable waste pickers have a lifestyle that makes this group highly vulnerable to unfavorable socio-economic and environmental factors. To date, the epidemiology of HEV infection in this population remains unknown.ObjectivesTo assess the seroprevalence of hepatitis E-specific antibodies in a population of recyclable waste pickers in Brazil.Study designBetween April 2010 and May 2011, a cross-sectional study was conducted among recyclable waste pickers from all 15 recycling cooperatives in Goiânia City, Central Brazil. The participants were tested for serological markers indicative of HEV infection.ResultsOf 432 individuals asked to participate in the survey, 431 (99.8%) agreed to participate. Twenty-four of 431 participants were anti-HEV IgG positive by ELISA. Of these, 22 were confirmed positive by immunoblot, resulting in an anti-HEV IgG prevalence of 5.1% (95% CI: 3.4–7.6). In addition, four individuals were anti-HEV IgM positive by ELISA. Of these, three (0.7%; 95% CI: 0.4–2.4) were confirmed anti-HEV IgM positive by immunoblot, but were HEV RNA negative. One was concurrently positive for anti-HEV IgG. Only age > 40 years was independently associated with the presence of anti-HEV.ConclusionsThese findings demonstrated that the prevalence of HEV antibodies among recyclable waste pickers in Central Brazil is relatively low and increased with age.     

Creating ‘therapeutic landscapes’ for mental health carers in inpatient settings: A dynamic perspective on permeability and inclusivity

Although there has been a shift toward treatment in the home and the community, in the UK, inpatient facilities are still important in modern mental health care. ‘Informal carers’, including family members, often play an essential role, not only in providing care in the community but also in care of patients during periods of hospitalisation. UK National Health Service policies increasingly consider the position of these carers as ‘partners’ in the care process, but relatively little attention has been paid to their position within the hospital settings where treatment is provided for inpatients. This paper contributes to geographical work on carers experiences, by reporting how this issue emerged through a study focused on perceptions of a newly built hospital, compared with the inpatient facilities it replaced. We draw on qualitative research findings from discussion groups and interviews with informal carers. The material considered here focused especially on carers' views of aspects of the hospital environment that were important for wellbeing of carers and the people they look after. The carers' views were supplemented by relevant material drawn from other interviews from our wider study, which included service users and members of hospital staff. These accounts revealed how informal carers experienced the hospital environment; we interpret our findings through a conceptual framework that emphasises carers' experiences of a ‘journey’ along a ‘caring pathway’ to and through the hospital space. This perspective allows us to make a connection between three bodies of literature. The first relates to phenomenological interpretations of one's environmental perception, formed as one moves through the world. The second derives from the literature concerning ‘permeability’ of hospital institutions. Bringing these ideas together provides an innovative, dynamic perspective on a third strand of literature from health geography that examines hospitals as ‘therapeutic landscapes’. The analysis helps to explore the extent to which carers in this study were positioned as ‘outsiders’ in the hospital space.     

Investigating the mental health implications of urban environments with neuroscientific methods and mobile technologies: A systematic literature review

Urbanization is an ongoing global process that is influencing and shaping individual mental health and well-being. This paper aims to provide an overview of the current literature containing state-of-the-art neuroscientific and mobile technologies that have been used to investigate the mental health implications of urban environments. Searches for peer-reviewed primary research articles were conducted in PubMed and SCOPUS, returning 33,443 papers; 90 empirical articles published from 1981 to 2021 were included in the final synthesis. Central findings suggest virtual reality and mobile electroencephalography to be the most commonly used methods, and demanding mood, affect, and health phenomena or states to be the most common concepts of study in both physical built settings and natural urban spaces. Recommendations for both future practice and study noting particular opportunities for future methodological contributions are discussed.     

Effects of the environment on bone mass: A human taphonomic study

An experiment was designed using human ribs placed in different environments to document how moisture and temperature affect the bone mass according to the postmortem interval. The bones were defleshed, weighed and partially buried, with some ribs being left unburied as controls. The ribs were weighed daily, and the mass loss was monitored over a period of 90 days. The results showed that significant differences in bone mass loss exist between environments, where the bone mass loss was significantly faster in an environment with low moisture content. This mass loss is thought to be primarily associated with the desiccation of the body and then for a greater part, with the atmospheric moisture content. However, the loss of bone mass can also be explained by early alterations in the organo-mineral matrix which were highlighted by Raman spectroscopy method.     

Families' experiences of living with pediatric epilepsy: A qualitative systematic review

Living with epilepsy in childhood has implications for the child and their family beyond the physical effects associated with epileptic seizures. Qualitative research has emerged, aiming to deliver a greater depth of understanding of the experiences of living with epilepsy from the perspectives of children with epilepsy, their parents, and their siblings. This review of qualitative research had three aims: first, to synthesize the demographic and epilepsy profiles of research participants in eligible studies in order to provide a clear picture of who are included and excluded when studying families' experiences; second, to present and discuss the methodological concerns and implications of research involving children with epilepsy; and third, to synthesize the findings arising from qualitative research with families in order to identify common themes across all relevant studies to date.Papers published in the English language prior to January 2016 were identified following a search of eight electronic databases: Embase, Psychinfo, Medline, CINAHL, Web of Knowledge, ASSIA, Web of Science, and SCOPUS. Studies were included if they involved a sample of children with epilepsy (up to 18 years of age), parents, or siblings of children with epilepsy and used qualitative methods. Twenty-one studies were identified as eligible for inclusion in the review.Findings in relation to the three aims were the following: 1) Researchers were seeking an understanding of children's experiences directly from children rather than by parental proxy. However, children with learning disabilities were often excluded from research, meaning that their views are not being heard. Parental research was predominantly with mothers, and father experiences were not often accessed. There was very little research with siblings. 2) The rationale for and ethical implications of the choice of research methods adopted were not always clear, and not all studies gave adequate attention to the development of appropriate methods for research involving children. 3) Two dominant themes emerged across the studies: normalcy and children's agency. Cutting across many of the challenges that living with epilepsy presented was the desire (by parents and children) for a ‘normal’ childhood. The studies also highlighted that children have knowledge about their own condition and epilepsy more generally and that they are involved in managing the ways in which they cope with epilepsy, both in terms of seizure prevention and managing their relations with others, particularly peers.Future research should ensure that appropriate design, data collection, and analytic strategies are adopted to facilitate the participation of all family members. Enhancing the quality of the research will, in turn, optimize validity and opportunities for the translation of findings into better health, education, and social practices to improve care for children and their families affected by epilepsy.     

Differences in cardiovascular disease mortality between local authorities in England: an ecological analysis

BackgroundLarge inequalities in age-standardised mortality rates of cardiovascular disease (CVD) exist at the local authority level within England, with particular areas consistently having the highest rates. Higher deprivation is associated with higher CVD mortality, but we know little about how the demographics and environments of local areas contribute to variations in mortality rates. The aim of this study was to explore the extent to which demographic, health, and environmental factors explain differences in all ages and premature CVD mortality between local authorities in England.MethodsAll data were sourced for each local authority in England. Outcome variables were age-standardised CVD mortality for all ages and those under 75 years in 2012–14. Data obtained were prevalence of ethnic and socioeconomic groups from the UK 2011 census; Public Health England data on index of multiple deprivation (IMD) score; prevalence of smoking, physical activity, obesity and overweightness; and Ordnance Survey environmental data on percentage of food shops, eating out shops, green or blue space, sporting facilities, and health facilities. We used the Akaike Information Criterion to assess which types of variables provided the best statistical model to explain variation in CVD mortality between local authorities.FindingsInclusion of health, demographic, environment, and IMD variables provided the best fit for explaining variation in CVD mortality at all ages (adjusted r²=0·60). Indian and Pakistani ethnicity and the IMD score in local authorities remained significantly associated with the outcome, with corresponding p values all less than 0·01. CVD mortality was 44 per 100 000 population greater in areas with the highest proportions of Indian and Pakistani ethnicities and 110 per 100 000 greater in the most deprived local authorities than in the least deprived areas. For CVD mortality below age 75, exclusion of environmental data improved the fit of the model (adjusted r²=0·82). Overweight prevalence (p=0·0481), Indian (p=0·0111), Pakistani (p=0·0003), and Bangladeshi (p=0·003) ethnicity, and the IMD score (p<0·0001) all remained significantly associated with premature CVD mortality when the best fitting model was used. Premature mortality was 13 per 100 000 and 18–25 per 100 000 greater in local authorities where the proportion of overweight people and Asian ethnicities was highest. Premature mortality in the most deprived local authorities was 68 per 100 000 greater than in the least deprived authorities.InterpretationThese findings are valuable for understanding which factors might be most useful for local authorities to target to reduce CVD mortality. This study combined a large amount of existing data; however, it was conducted at an ecological level, so analyses using individual-level mortality outcomes are also needed.FundingThe authors' posts are funded by the British Heart Foundation.     

Subsistence agriculture and child growth in Papua New Guinea

Spatial statistical analyses of child anthropometric data were undertaken to assess the influence of systems of subsistence agriculture, in terms of staple foods and cash crops cultivated, on patterns of child growth in Papua New Guinea. These agricultural data explained between a quarter and half of the geographical variation in anthropometric growth indicators. Accounting for differences in altitude, relief and rainfall patterns, though explaining additional geographical variation, did not improve the predictions. Child growth was better in agriculture systems with cassava and sweet potato as staple crops, but worse in systems where banana, sago and taro were staple crops. Both the cultivation of all major cash crops, and sales of fish and food crops improved child growth. More intensive agricultural systems were associated with larger children indicating that the nutritional status of children benefited from intensification as well as from the introduction of cash crops into traditional subsistence systems.