Effect of exposure to natural environment on health inequalities: an observational population study

<b>Background:</b> Studies have shown that exposure to the natural environment, or so-called green space, has an independent effect on health and health-related behaviours. We postulated that income-related inequality in health would be less pronounced in populations with greater exposure to green space, since access to such areas can modify pathways through which low socio-economic position can lead to disease.<p></p> <b>Methods:</b> We classified the population of England at younger than retirement age (n=40 813 236) into groups on the basis of income deprivation and exposure to green space. We obtained individual mortality records (n=366 348) to establish whether the association between income deprivation, all-cause mortality, and cause-specific mortality (circulatory disease, lung cancer, and intentional self-harm) in 2001—05, varied by exposure to green space measured in 2001, with control for potential confounding factors. We used stratified models to identify the nature of this variation.<p></p> <b>Findings:</b> The association between income deprivation and mortality differed significantly across the groups of exposure to green space for mortality from all causes (p<0·0001) and circulatory disease (p=0·0212), but not from lung cancer or intentional self-harm. Health inequalities related to income deprivation in all-cause mortality and mortality from circulatory diseases were lower in populations living in the greenest areas. The incidence rate ratio (IRR) for all-cause mortality for the most income deprived quartile compared with the least deprived was 1·93 (95% CI 1·86—2·01) in the least green areas, whereas it was 1·43 (1·34—1·53) in the most green. For circulatory diseases, the IRR was 2·19 (2·04—2·34) in the least green areas and 1·54 (1·38—1·73) in the most green. There was no effect for causes of death unlikely to be affected by green space, such as lung cancer and intentional self-harm.<p></p> <b>Interpretation:</b> Populations that are exposed to the greenest environments also have lowest levels of health inequality related to income deprivation. Physical environments that promote good health might be important to reduce socio-economic health inequalities.<p></p&gt

Noncommunicable diseases and injuries in Latin America and the Caribbean: Time for action

The region is in a privileged position to quickly translate investment in health research into practice, argue Perel and colleagues

Effecting change in primary care management of respiratory conditions : a global scoping exercise and literature review of educational interventions to inform the IPCRG's E-Quality initiative

This discussion paper describes a scoping exercise and literature review commissioned by the International Primary Care Respiratory Group (IPCRG) to inform their E-Quality programme which seeks to support small-scale educational projects to improve respiratory management in primary care. Our narrative review synthesises information from three sources: publications concerning the global context and health systems development; a literature search of Medline, CINAHL and Cochrane databases; and a series of eight interviews conducted with members of the IPCRG faculty. Educational interventions sit within complex healthcare, economic, and policy contexts. It is essential that any development project considers the local circumstances in terms of economic resources, political circumstances, organisation and administrative capacities, as well as the specific quality issue to be addressed. There is limited evidence (in terms of changed clinician behaviour and/or improved health outcomes) regarding the merits of different educational and quality improvement approaches. Features of educational interventions that were most likely to show some evidence of effectiveness included being carefully designed, multifaceted, engaged health professionals in their learning, provided ongoing support, were sensitive to local circumstances, and delivered in combination with other quality improvement strategies. To be effective, educational interventions must consider the complex healthcare systems within which they operate. The criteria for the IPCRG E-Quality awards thus require applicants not only to describe their proposed educational initiative but also to consider the practical and local barriers to successful implementation, and to propose a robust evaluation in terms of changed clinician behaviour or improved health outcomes.The IPCRG commissioned this work as part of the IPCRG e-Quality initiative. HP is supported by a Primary Care Research Career Award from the Chief Scientist's Office of the Scottish Government

Caribbean Corals in Crisis: Record Thermal Stress, Bleaching, and Mortality in 2005

BACKGROUND. The rising temperature of the world's oceans has become a major threat to coral reefs globally as the severity and frequency of mass coral bleaching and mortality events increase. In 2005, high ocean temperatures in the tropical Atlantic and Caribbean resulted in the most severe bleaching event ever recorded in the basin. METHODOLOGY/PRINCIPAL FINDINGS. Satellite-based tools provided warnings for coral reef managers and scientists, guiding both the timing and location of researchers' field observations as anomalously warm conditions developed and spread across the greater Caribbean region from June to October 2005. Field surveys of bleaching and mortality exceeded prior efforts in detail and extent, and provided a new standard for documenting the effects of bleaching and for testing nowcast and forecast products. Collaborators from 22 countries undertook the most comprehensive documentation of basin-scale bleaching to date and found that over 80% of corals bleached and over 40% died at many sites. The most severe bleaching coincided with waters nearest a western Atlantic warm pool that was centered off the northern end of the Lesser Antilles. CONCLUSIONS/SIGNIFICANCE. Thermal stress during the 2005 event exceeded any observed from the Caribbean in the prior 20 years, and regionally-averaged temperatures were the warmest in over 150 years. Comparison of satellite data against field surveys demonstrated a significant predictive relationship between accumulated heat stress (measured using NOAA Coral Reef Watch's Degree Heating Weeks) and bleaching intensity. This severe, widespread bleaching and mortality will undoubtedly have long-term consequences for reef ecosystems and suggests a troubled future for tropical marine ecosystems under a warming climate.NOAA Coral Reef Conservation Progra

Caribbean Corals in Crisis: Record Thermal Stress, Bleaching, and Mortality in 2005

BACKGROUND The rising temperature of the world's oceans has become a major threat to coral reefs globally as the severity and frequency of mass coral bleaching and mortality events increase. In 2005, high ocean temperatures in the tropical Atlantic and Caribbean resulted in the most severe bleaching event ever recorded in the basin. METHODOLOGY/PRINCIPAL FINDINGS Satellite-based tools provided warnings for coral reef managers and scientists, guiding both the timing and location of researchers' field observations as anomalously warm conditions developed and spread across the greater Caribbean region from June to October 2005. Field surveys of bleaching and mortality exceeded prior efforts in detail and extent, and provided a new standard for documenting the effects of bleaching and for testing nowcast and forecast products. Collaborators from 22 countries undertook the most comprehensive documentation of basin-scale bleaching to date and found that over 80% of corals bleached and over 40% died at many sites. The most severe bleaching coincided with waters nearest a western Atlantic warm pool that was centered off the northern end of the Lesser Antilles. CONCLUSIONS/SIGNIFICANCE Thermal stress during the 2005 event exceeded any observed from the Caribbean in the prior 20 years, and regionally-averaged temperatures were the warmest in over 150 years. Comparison of satellite data against field surveys demonstrated a significant predictive relationship between accumulated heat stress (measured using NOAA Coral Reef Watch's Degree Heating Weeks) and bleaching intensity. This severe, widespread bleaching and mortality will undoubtedly have long-term consequences for reef ecosystems and suggests a troubled future for tropical marine ecosystems under a warming climate.This work was partially supported by salaries from the NOAA Coral Reef Conservation Program to the NOAA Coral Reef Conservation Program authors. NOAA provided funding to Caribbean ReefCheck investigators to undertake surveys of bleaching and mortality. Otherwise, no funding from outside authors' institutions was necessary for the undertaking of this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Enabling New ALMA Science with Improved Support for Time-Domain Observations

While the Atacama Large Millimeter/submillimeter Array (ALMA) is a uniquely powerful telescope, its impact in certain fields of astrophysics has been limited by observatory policies rather than the telescope's innate technical capabilities. In particular, several observatory policies present challenges for observations of variable, mobile, and/or transient sources --- collectively referred to here as "time-domain" observations. In this whitepaper we identify some of these policies, describe the scientific applications they impair, and suggest changes that would increase ALMA's science impact in Cycle 6 and beyond. Parties interested in time-domain science with ALMA are encouraged to join the ALMA Time-domain Special Interest Group (ATSIG) by signing up for the ATSIG mailing list at https://groups.google.com/group/alma-td-sig

Enabling New ALMA Science with Improved Support for Time-Domain Observations

While the Atacama Large Millimeter/submillimeter Array (ALMA) is a uniquely powerful telescope, its impact in certain fields of astrophysics has been limited by observatory policies rather than the telescope's innate technical capabilities. In particular, several observatory policies present challenges for observations of variable, mobile, and/or transient sources --- collectively referred to here as "time-domain" observations. In this whitepaper we identify some of these policies, describe the scientific applications they impair, and suggest changes that would increase ALMA's science impact in Cycle 6 and beyond. Parties interested in time-domain science with ALMA are encouraged to join the ALMA Time-domain Special Interest Group (ATSIG) by signing up for the ATSIG mailing list at https://groups.google.com/group/alma-td-sig

A genome-wide CRISPR screen identifies a restricted set of HIV host dependency factors

Host proteins are essential for HIV entry and replication and can be important nonviral therapeutic targets. Large-scale RNA interference (RNAi)-based screens have identified nearly a thousand candidate host factors, but there is little agreement among studies and few factors have been validated. Here we demonstrate that a genome-wide CRISPR-based screen identifies host factors in a physiologically relevant cell system. We identify five factors, including the HIV co-receptors CD4 and CCR5, that are required for HIV infection yet are dispensable for cellular proliferation and viability. Tyrosylprotein sulfotransferase 2 (TPST2) and solute carrier family 35 member B2 (SLC35B2) function in a common pathway to sulfate CCR5 on extracellular tyrosine residues, facilitating CCR5 recognition by the HIV envelope. Activated leukocyte cell adhesion molecule (ALCAM) mediates cell aggregation, which is required for cell-to-cell HIV transmission. We validated these pathways in primary human CD4 + T cells through Cas9-mediated knockout and antibody blockade. Our findings indicate that HIV infection and replication rely on a limited set of host-dispensable genes and suggest that these pathways can be studied for therapeutic intervention

Teacher support, preparedness and resilience during times of crises and uncertainty: COVID-19 and education in the Global South

The COVID-19 pandemic has exacerbated existing education inequities, further marginalising those with poor and limited education opportunities, particularly in conflict, fragile and insecure contexts (Sayed & Singh, 2020). In the Global South, the COVID-19 pandemic compounds existing crises, frailties and inequities as the impoverished suffer food insecurity, physical conflict and crises of health and water. Drawing on research, commissioned by the Open Society Foundation and Education International, based on interviews with purposefully selected teachers’ union and government officials in eight African countries and a detailed desk-based review, the paper examines the role of teachers in education policy responses to the pandemic and the kinds of support (or lack thereof) availed to teachers. Using the conceptual framing of de Sousa Santos’ (2001,2014) sociology of absences and cognitive injustice, the paper demonstrates that teachers have been absent in policymaking processes, and have not been adequately provided with the necessary professional development and psychosocial support to navigate the uncertainties and  pedagogical requirements imposed by the COVID-19 pandemi