Water, Sanitation and Hygiene: Interventions and Diarrhoea - A Systematic Review and Meta-analysis

This paper provides a formal systematic review and meta-analysis examining the evidence of the effectiveness of interventions intended to reduce illness through improvements in drinking water, sanitation facilities and hygiene practices. The comprehensive literature search and bibliographic review shows that in developing countries, water quality interventions, specifically point-of-use treatment, reduced diarrhea illness levels, but this effect was mainly seen with the provision of household connections and use of water without household storage. Hygiene interventions, especially those promoting hand-washing, were effective. Only limited data were available for sanitation interventions, but these suggested effectiveness in reducing diarrhea. Multifactorial interventions consisting of water supply, sanitation and hygiene education acted to reduce diarrhea but were not more effective than individual interventions

Is slower early growth beneficial for long-term cardiovascular health?

Background - Accelerated neonatal growth increases the later propensity to cardiovascular disease (CVD) in animals, whereas slower growth is thought to have a beneficial effect. To test this hypothesis in humans, we measured flow-mediated endothelium-dependent dilation (FMD) in a population subject to slower early growth and in healthy controls.Methods and Results - High-resolution vascular ultrasound was used to measure the change in brachial artery diameter in response to reactive hyperemia in adolescents age 13 to 16 years who were either part of a cohort born preterm and followed up prospectively (n = 216) or controls born at term ( n = 61). Greater weight gain or linear growth in the first 2 weeks postnatally was associated with lower FMD at adolescence ( regression coefficient, - 0.026-mm change in mean arterial diameter per 100-g increase in weight; 95% CI, - 0.040 to - 0.012 mm; P = 0.0003) independent of birthweight and potential confounding factors. Mean FMD in the half of the preterm population with the lowest rates of early growth was higher than in both the half with the greatest growth ( P = 0.001) and subjects born at term ( P = 0.03).Conclusions - FMD was 4% lower in adolescents with the highest compared with the lowest rate of weight gain in the first 2 weeks after birth, a substantial negative effect similar to that for insulin-dependent diabetes mellitus or smoking in adults. Our findings are consistent with the adverse effects of accelerated neonatal growth on long-term cardiovascular health and suggest that postnatal growth patterns could explain the previously reported association between birthweight and later CVD

The test-retest reliability of different ankle joint center location techniques

Accurate and reliable joint identification is imperative for the collection of meaningful kinetic and kinematic data. Of the lower kinetic chain both the hip and knee joints have received a considerable amount of attention in 3D modelling. However, the reliability of methods to define the ankle joint center have received very little attention. This study investigated the reliability of the two marker method (TMM) and the functional ankle method (FAM) on estimating the ankle joint center. Furthermore, the effects of the two-marker method reliability for defining the ankle joint center when the ankle was covered with a brace or protector was investigated. 3D kinematic data was collected from ten participants (8 female and 2 male) whilst walking. The ankle joint center was defined twice using each test condition; TMM (WITHOUT), FAM (FUNCTIONAL), TMM when the ankle was covered with a brace (BRACE), and TMM when the ankle was covered with a protector (PROTECTOR). Intraclass correlations (ICC) were utilised to compare test and retest waveforms and paired samples t-tests were used to compare angular parameters. Significant differences were found in the test-retest angular parameters in the transverse and sagittal planes for the WITHOUT, BRACE, and FUNCTIONAL conditions. The strongest test-retest ICC’s were observed in the WITHOUT and PROTECTOR conditions. The findings of the current investigation indicate that there are fewer errors using the TMM when the ankle is uncovered or when covered with soft foam that is easy to palpate through

Three-dimensional kinematic correlates of ball velocity during maximal instep soccer kicking in males

This is an Accepted Manuscript of an article published by Taylor & Francis Group in European Journal of Sport Science, on 23 April 2014, available online at: https://www.tandfonline.com/doi/abs/10.1080/17461391.2014.908956.Achieving a high ball velocity is important during soccer shooting, as it gives the goalkeeper less time to react, thus improving a player's chance of scoring. This study aimed to identify important technical aspects of kicking linked to the generation of ball velocity using regression analyses. Maximal instep kicks were obtained from 22 academy-level soccer players using a 10-camera motion capture system sampling at 500 Hz. Three-dimensional kinematics of the lower extremity segments were obtained. Regression analysis was used to identify the kinematic parameters associated with the development of ball velocity. A single biomechanical parameter; knee extension velocity of the kicking limb at ball contact Adjusted R(2) = 0.39, p ≤ 0.01 was obtained as a significant predictor of ball-velocity. This study suggests that sagittal plane knee extension velocity is the strongest contributor to ball velocity and potentially overall kicking performance. It is conceivable therefore that players may benefit from exposure to coaching and strength techniques geared towards the improvement of knee extension angular velocity as highlighted in this study.Peer reviewedFinal Accepted Versio

Evaluation of air-displacement plethysmography in children aged 5-7 years using a three-component model of body composition

The aim of the present study was to evaluate air-displacement plethysmography (ADP) in children aged 5-7 years. Body-composition measurements were obtained by ADP, H-2 dilution and anthropometry in twenty-eight children. Calculation of body volume by ADP was undertaken using adult and children's equations for predicting lung volume and surface area. Fat-free mass (FFM) was calculated using a three-component model. Measured FFM hydration was then compared with values from the reference child. Differences between measured and reference hydration were back-extrapolated, to calculate the error in ADP that would account for any disagreement. Propagation of error was used to distinguish the contributions of methodological precision and biological variability to total hydration variability. The use of children's equations influenced the results for lung volume but not surface area. The mean difference between measured and reference hydration was 0.6 (SD 1.7) % (P<0.10), equivalent to an error in body volume of 0.04 (So 0.20) litres (P<0.30), and in percentage fat of 0.4 (SD 1.9) (P<0.28). The limits of agreement in individuals could be attributed to methodological precision and biological variability in hydration. It is concluded that accuracy of ADP was high for the whole group, with a mean bias of <0.5% fat using the three-component model, and after taking into account biological variability in hydration, the limits of agreement were around 2 % fat in individuals. Paediatric rather than adult equations for lung volume estimation should be used

Influence of leptin on arterial distensibility - A novel link between obesity and cardiovascular disease?

Background-The mechanisms by which obesity increases the risk of atherosclerotic cardiovascular disease (CVD) are poorly understood. In experimental models, leptin, a hormone produced by adipose tissue, has been shown adversely to affect vascular health. Therefore, we tested the hypothesis that high leptin concentrations are associated with lower arterial distensibility, an index of circulatory function relevant to the atherosclerotic process.Methods and Results-Noninvasive, high-resolution, vascular ultrasound was used to measure brachial artery distensibility in 294 healthy adolescents (aged 13 to 16 years) who had a broad range of body mass indexes. Fat mass was measured by bioelectric impedance analysis; fasting serum leptin concentration by radioimmunoassay; and lipid profile, fasting insulin, glucose, and C-reactive protein concentrations by standard laboratory techniques. Higher leptin concentrations were associated with impaired arterial distensibility (regression coefficient, -1.3% change in arterial distension per 10% increase in leptin; 95% CI, -1.9% to -0.8%; P<0.001). This association was independent of fat mass, blood pressure, and C-reactive protein, fasting insulin, or LDL cholesterol concentrations.Conclusions-Elevation in leptin was associated with impaired vascular function, independent of the metabolic and inflammatory disturbances associated with obesity. Our observations are consistent with data from experimental models and suggest that high leptin concentration is an important mechanism for the adverse influence of body fatness on CVD

Iron Status at Age 6 Months in Colombian Infants Exclusively Breast-fed for 4-5 Versus 6 Months.

BACKGROUND: The optimal age for introducing complementary feeding to breast-fed infants may differ depending on the setting. Prolonged exclusive breastfeeding (EBF) protects against infection but may increase the risk of iron deficiency (ID)/anaemia (IDA) in vulnerable infants. AIM: To compare haemoglobin (Hb), serum ferritin (SF)), anaemia (Hb  2500 g), all EBF for ≥4 months. RESULTS: 108 infants (54% boys) were recruited; 46% EBF for 4-5mo, 54% EBF at 6mo. Prevalence of anaemia, ID and IDA was 20%, 10% and 5%, with no significant difference between EBF4-5 and EBF6 groups. In multivariate models, anaemia/ID were predicted by greater weight gain from 0-6 mo, and anaemia also by caesarean delivery; Hb was lower in infants with higher intake of cows' milk; SF was lower in boys and those with greater weight gain. EBF4-5 versus EBF6 was not a significant predictor of any outcome. CONCLUSION: Anaemia and ID were common at 6 months but were not affected by EBF for 4-5 versus 6 months, suggesting 6 months EBF is safe in this population. However, further research is required to examine effects on later iron status. The findings highlight the need to emphasise avoidance of cow's milk before 12 months

A re-assessment of the safety of silver in household water treatment: rapid systematic review of mammalian in vivo genotoxicity studies

Background: Despite poor evidence of their effectiveness, colloidal silver and silver nanoparticles are increasingly being promoted for treating potentially contaminated drinking water in low income countries. Recently, however, concerns have been raised about the possible genotoxicity of particulate silver. Objectives: The goal of this paper was to review the published mammalian in vivo genotoxicity studies using silver micro and nanoparticles. Methods: SCOPUS and Medline were searched using the following search string: (“DNA damage” OR genotox* OR Cytotox* OR Embryotox*) AND (silver OR AgNP). Included papers were any mammalian in vivo experimental studies investigating genotoxicity of silver particles. Studies were quality assessed using the ToxRTool. Results: 16 relevant papers were identified. There were substantial variations in study design including the size of silver particles, animal species, target organs, silver dose, route of administration and the method used to detect genotoxicity. Thus, it was not possible to produce a definitive pooled result. Nevertheless, most studies showed evidence of genotoxicity unless using very low doses. We also identified one human study reporting evidence of “severe DNA damage” in silver jewellery workers occupationally exposed to silver particles. Conclusions: With the available evidence it is not possible to be definitive about risks to human health from oral exposure to silver particulates. However, the balance of evidence suggests that there should be concerns especially when considering the evidence from jewellery workers. There is an urgent need to determine whether people exposed to particulate silver as part of drinking water treatment have evidence of DNA damage