Particulate pollution from brick kiln clusters in the Greater Dhaka region, Bangladesh

Brick manufacturing is the fastest-growing industrial sector in Bangladesh and among the top three sectors, along with vehicle exhaust and resuspended road dust, contributing to the air pollution and health problems in Dhaka. The brick manufacturing in the Greater Dhaka region, from ~1,000 brick kilns spread across six districts, is confined to the winter season (October to March) as current technologies do not allow production during the monsoon. The total emissions are estimated at 23,300 t of PM_2.5, 15,500 t of sulfur dioxide (SO₂), 302,000 t of carbon monoxide (CO), 6,000 t of black carbon, and 1.8 million?tons of CO₂ emissions from these clusters, to produce 3.5 billion bricks per year, using energy-inefficient fixed chimney bull trench kiln technology and predominantly using coal and agricultural waste as fuel. The associated health impacts largely fall on the densely populated districts of Dhaka Metropolitan Area (DMA), Gazipur, and Narayanganj. Using the Atmospheric Transport Modeling System dispersion model, the impact of brick kiln emissions was estimated over DMA—ranging from 7 to 99 μg/m³ (5th and 95th percentile concentration per model grid) at an average of 38 μg/m³; and spatial contributions from the surrounding clusters—with 27 % originating from Narayanganj (to the south with the highest kiln density), 30 % from Gazipur (to the north with equally large cluster spread along the river and canals), and 23 % from Savar. The modeling results are validated using evidence from receptor modeling studies conducted in DMA. An introduction of emerging vertical shaft combustion technology can provide faster benefits for public health in DMA and reduce climate precursor emissions by selecting the most influential clusters discussed in this paper.     

Eosinophilia associated with proliferation of CD3+4−8−αβ+ T cells with chromosome 16 anomalies

We describe a patient with eosinophilia and an abnormal CD3⁺4⁻8⁻αβ⁺ T-cell population. Chromosomal analysis of sorted CD3⁺4⁻8⁻ cells revealed abnormal karyotypes on chromosome 16. In the presence of IL-2 the production of IL-5 from CD3⁺4⁻8⁻ cells was higher than that from CD3⁺4⁺/8⁺ cells. Eosinophil survival-enhancing activity in the patient serum was inhibited by a combination of anti-IL-5 and anti-GM-CSF monoclonal antibodies. These data suggest that increased production of IL-5 and GM-CSF from the abnormal CD3⁺4⁻8⁻ cells might cause eosinophilia.     

Integrating Ethnicity and Migration As Determinants of Canadian Women's Health

HEALTH ISSUE: This chapter investigates (1) the association between ethnicity and migration, as measured by length of residence in Canada, and two specific self-reported outcomes: (a) self-perceived health and (b) self-reports of chronic conditions; and (2) the extent to which these selected determinants provide an adequate portrait of the differential outcomes on Canadian women's self-perceived health and self-reports of chronic conditions. The 2000 Canadian Community Health Survey was used to assess these associations while controlling for selected determinants such as age, sex, family structure, highest level of education attained and household income. KEY FINDINGS: * Recent immigrant women (2 years or less in Canada) are more likely to report poor health than Canadian-born women (OR = 0.48 CI: 0.30-0.77). Immigrant women who have been in Canada 10 years and over are more likely to report poor health than Canadian-born women (OR = 1.31 CI: 1.18-1.45).* Although immigrant women are less likely to report chronic conditions than Canadian-born women, this health advantage decreased over time in Canada (OR from 0.35 to 0.87 for 0-2 years to 10 years and above compared with Canadian born women). DATA GAPS AND RECOMMENDATIONS: * Migration experience needs to be conceptualized according to the results of past studies and included as a social determinant of health above and beyond ethnicity and culture. It is expected that the upcoming longitudinal survey of immigrants will help enhance surveillance capacity in this area.* Variables need to be constructed to allow women and men to best identify themselves appropriately according to ethnic identity and number of years in the host country; some of the proposed categories used as a cultural group may simply refer to skin colour without capturing associated elements of culture, ethnicity and life experiences.     

Do paediatric research presentations at local meetings get published?

Accessibility of research done locally to clinicians remains limited unless it is in the published form. The publication rate of research presentations at the Annual Malaysian Paediatric Association, Perinatal Society of Malaysia and Academy of Medicine Malaysia in 1997 and 1998 was determined. One hundred and five (95.5%) of 110 research presentations were carried out in Malaysia. Thirty-seven (35.2%) presentations were published. University-affiliated institutions were more likely to publish their research presentations as compared to Ministry of Health hospitals (OR 3.1 95% CI 1.4-6.8, p < 0.01). There is a need to encourage publication of local research presentations. University-affiliated institutions performed better due to institution pressure for career advancement.     

A research partnership in a multiethnic setting

The objective of this paper is to describe a research partnership endeavour with five community organizations focusing their work on facilitating the integration of immigrant populations in the Montreal area. Survey data were collected in order to obtain a sociodemographic picture of recent immigrant women (n = 254), their knowledge of Info-Santé CLSC services and their use of those services. Focus group discussions were also carried out to explore the needs of these women with regards to the various services offered by Info-Santé CLSC (n = 44). Among these women, some had previously used the services and others not. The community organizations were the main crafters of this research partnership across the various stages from its inception to evaluation. The success factors of such a partnership are discussed according to human, professional and organizational dimensions.     

Pulmonary atresia with intact ventricular septum percutaneous radiofrequency-assisted valvotomy and balloon dilation versus surgical valvotomy and Blalock Taussig shunt

OBJECTIVE: We compared the result of radiofrequency (RF)-assisted valvotomy and balloon dilation with closed surgical valvotomy and Blalock Taussig (BT) shunt as primary treatment in selected patients with pulmonary atresia and intact ventricular septum (PA-IVS). BACKGROUND: Patients with PA-IVS who have mild to moderate hypoplasia of the right ventricle (RV) and patent infundibulum have the greatest potential for complete biventricular circulation. The use of RF or laser wires to perforate the atretic valve followed by balloon dilation provides an alternative to surgery. METHODS: Between May 1990 and March 1998, 33 selected patients underwent either percutaneous RF valvotomy and balloon dilation (group 1, n = 21; two crossed over to group 2) or surgical valvotomy with concomitant BT shunt (group 2, n = 14). Second RV decompression by balloon dilation or right ventricular outflow tract (RVOT) reconstruction were performed if necessary. Patients who remained cyanosed were subjected to transcatheter trial closure of the interatrial communication. Partial biventricular repair was offered to those with inadequate growth of the RV. RESULTS: The primary procedure was successful in 19 patients in group 1. There was one in-hospital death and two late deaths. Of the remaining 16 survivors, 12 achieved complete biventricular circulation, 7 of whom required no further interventions. Two patients required repeat balloon dilation, 1 RVOT reconstruction and 2 transcatheter closure of interatrial communication. Two patients underwent partial biventricular repair. In group 2, there were 3 in-hospital deaths after the primary procedure and 1 patient died four months later. All survivors (n = 10) required a second RV decompression, 8 by balloon dilation and 2 by RVOT reconstruction, after which, two patients died. Of the final 8 survivors, 7 achieved complete biventricular circulation, 5 after coil occlusion of the BT shunt and 2 after closure of interatrial communication. CONCLUSIONS: Radiofrequency valvotomy and balloon dilation is more efficacious and safe compared with closed pulmonary valvotomy and BT shunt in selected patients with PA-IVS.