Population attributable risk of unintentional childhood poisoning in Karachi Pakistan

Background

The percentage of unintentional childhood poisoning cases in a given population attributable to specific risk factors (i.e., the population attributable risk) which can be calculated; determination of such risk factors associated with potentially modifiable risk factors, are necessary to focus on the prevention strategies.

Methods

We calculated PARs, using 120 cases with unintentional poisoning and 360 controls in a hospital based matched case- control study. The risk factors were accessibility to hazardous chemicals and medicines due to unsafe storage, child behavior reported as hyperactive, storage of kerosene and petroleum in soft drink bottles, low socioeconomic class, less education of the mother and the history of previous poisoning.

Results

The following attributed risks were observed: 12% (95% confidence interval [CI] = 8%–16%) for both chemicals and medicines stored unsafe, 19% (15%–23%) for child reported as hyperactive, 40% (38%–42%) for storage of kerosene and petroleum in soft drink bottles, 48% (42%–54%) for low socioeconomic status, 38% (32%–42%) for no formal mothers education and 5.8% (2%–10%) for history of previous poisoning. 48% of cases for overall study population which could be attributed to at least one of the six risk factors. Among girls, this proportion was 23% and 43% among boys. About half of the unintentional childhood poisoning cases in this Pakistani population could be avoided.

Conclusion

Exposure to potentially modifiable risk indicators explained about half of the cases of unintentional poisoning among children under five years of age in this Pakistani population, indicating the theoretical scope for prevention of the disease.     

Peatland conservation — from cinders to Cinderella

Peatlands are rare and extraordinary habitats which hover on the borderline between the aquatic and the terrestrial, but the steady loss of Britain's peatlands has gone unremarked until recently. In lowland England some 37000 ha have been reduced to less than 500 ha of natural bog and losses on such a scale are found throughout Europe.     

Beyond the “Cinderella effect”

A central thesis of this paper is that understanding the nature of child maltreatment is so complex that no one disciplinary specialty is likely to be sufficient for the task. Although life history theory is the guiding principle for our analysis, we argue that an evolutionary explanation adds precision by incorporating empirical findings originating from the fields of anthropology; clinical, developmental, and social psychology; and sociology. Although evolutionary accounts of child maltreatment have been largely limited to the role of the coefficient of relatedness, the prospective reproductive value of a child, and the residual reproductive potential of parents, a case is made for expanding this basic application. An explanatory model is presented that describes how ecological conditions as well as parental and child traits interact to influence the degree of parental investment. As shown in the model, these various “marker variables” alter parental perceptions of the benefits and costs associated with child care and promote low-investment parenting, which leads to disrupted family management practices and to a downward-spiraling, self-perpetuating system of coercive family interaction, increased parental rejection of the child, and even lower parental investment. Child maltreatment is the ultimate outcome of this downward trajectory of family relations.     

Equipment management: the Cinderella of bio-engineering

In recent years the work associated with equipment maintenance has become increasingly important. As concern for efficiency grows, the use of expensive equipment is questioned more closely. The running costs associated with such equipment are seen to be of growing relevance. Nonetheless, it is important to examine the work of maintenance departments, to identify the salient features and to ensure that the service is run as efficiently as possible. It becomes clear that the necessary support is considerably more than mere maintenance. Complete equipment management must be provided. Further, appropriate performance indicators must be developed, not only to allow overall efficiency to be examined, but also to assist in the daily running of the service. Examples are drawn from a typical equipment management department.     

Cytokinins,the Cinderella of plant growth regulators

Phytochemistry Reviews - Cytokinins (CKs) are a complex group of compounds. The complexity of CKs is not just present at the level of chemical structures, but as a family of compounds. CKs occur in...     

An approach to the management of unintentional weight loss in elderly people

UNINTENTIONAL WEIGHT LOSS, or the involuntary decline in total body weight over time, is common among elderly people who live at home. Weight loss in elderly people can have a deleterious effect on the ability to function and on quality of life and is associated with an increase in mortality over a 12-month period. A variety of physical, psychological and social conditions, along with age-related changes, can lead to weight loss, but there may be no identifiable cause in up to one-quarter of patients. We review the incidence and prevalence of weight loss in elderly patients, its impact on morbidity and mortality, the common causes of unintentional weight loss and a clinical approach to diagnosis. Screening tools to detect malnutrition are highlighted, and nonpharmacologic and pharmacologic strategies to minimize or reverse weight loss in older adults are discussed.Unintentional weight loss is the involuntary decline in total body weight over time. In clinical practice, it is encountered in up to 8% of all adult outpatients¹ and 27% of frail people 65 years and older.² Weight loss is an important risk factor in elderly patients. It is associated with increased mortality, which can range from 9% to as high as 38% within 1 to 2.5 years after weight loss has occurred.^1,3,4 Frail elderly people,⁵ people with low baseline body weight,^5,6,7 and elderly patients recently admitted to hospital are particularly susceptible to increased mortality.^8,9 Weight loss is also associated with an increased risk of in-hospital complications,^10,11 a decline in activities of daily living or physical function,^12,13 higher rates of admission to an institution^2,8 and poorer quality of life.¹⁴     

Cinderella story: PI4P goes from precursor to key signaling molecule

Abstract

Phosphatidylinositol lipids are signaling molecules involved in nearly all aspects of cellular regulation. Production of phosphatidylinositol 4-phosphate (PI4P) has long been recognized as one of the first steps in generating poly-phosphatidylinositol phosphates involved in actin organization, cell migration, and signal transduction. In addition, progress over the last decade has brought to light independent roles for PI4P in membrane trafficking and lipid homeostasis. Here, we describe recent advances that reveal the breadth of processes regulated by PI4P, the spectrum of PI4P effectors, and the mechanisms of spatiotemporal control that coordinate crosstalk between PI4P and cellular signaling pathways.     

A Cinderella effect in the childcare assistance provided by European grandparents

Survey data from 36,771 European grandparents were analyzed with respect to childcare assistance that interviewees provided to their birth children versus stepchildren. Interviewees with current partners provided far more such assistance to adult children who were the progeny of both partners than to those who were stepchildren of either one's self or one's partner, but both husband and wife helped the wife's children from prior unions more than they helped the husband's children, supporting the interpretation of stepfathers' involvement as primarily an investment in the new partnership (“mating effort”) rather than in the grandchildren. Interviewees resided farther away from their adult stepchildren than from their birth children, on average, but discriminative care did not depend merely on residential proximity, being substantial regardless of whether proximity was statistically controlled. Grandmothers without current partners exhibited the greatest discrimination, with stepchild: birth child Odds Ratios of 0.10 or less in various analyses, whereas grandfathers without partners exhibited no significant discrimination. Interviewees of both sexes listed far more stepchildren, proportionately, if they had a current partner than if they were either widowed or divorced, however, which suggests that single respondents may have omitted former stepchildren with whom they had ceased to interact from their list of children, and hence that the degree to which single grandparents divest from them may be even larger than estimated.     

Methionine in proteins: The Cinderella of the proteinogenic amino acids

Methionine in proteins, apart from its role in the initiation of translation, is assumed to play a simple structural role in the hydrophobic core, in a similar way to other hydrophobic amino acids such as leucine, isoleucine, and valine. However, research from a number of laboratories supports the concept that methionine serves as an important cellular antioxidant, stabilizes the structure of proteins, participates in the sequence‐independent recognition of protein surfaces, and can act as a regulatory switch through reversible oxidation and reduction. Despite all these evidences, the role of methionine in protein structure and function is largely overlooked by most biochemists. Thus, the main aim of the current article is not so much to carry out an exhaustive review of the many and diverse processes in which methionine residues are involved, but to review some illustrative examples that may help the nonspecialized reader to form a richer and more precise insight regarding the role‐played by methionine residues in such processes.     

A novel category of antigens enabling CTL immunity to tumor escape variants: Cinderella antigens

Deficiencies in MHC class I antigen presentation are a common feature of tumors and allows escape from cytotoxic T lymphocyte (CTL)-mediated killing. It is crucial to take this capacity of tumors into account for the development of T-cell-based immunotherapy, as it may strongly impair their effectiveness. A variety of escape mechanisms has been described thus far, but progress in counteracting them is poor. Here we review a novel strategy to target malignancies with defects in the antigenic processing machinery (APM). The concept is based on a unique category of CD8⁺ T-cell epitopes that is associated with impaired peptide processing, which we named TEIPP. We characterized this alternative peptide repertoire emerging in MHC-I on tumors lacking classical antigen processing due to defects in the peptide transporter TAP (transporter associated with peptide processing). These TEIPPs exemplify interesting parallels with the folktale figure Cinderella: they are oppressed and neglected by a stepmother (like functional TAP prevents TEIPP presentation), until the suppression is released and Cinderella/TEIPP achieves unexpected recognition. TEIPP-specific CTLs and their cognate peptide-epitopes provide a new strategy to counteract immune evasion by APM defects and bear potential to targeting escape variants observed in a wide range of cancers.     

Impact of unintentional selective harvesting on the population dynamics of red grouse

1.?The effect of selective exploitation of certain age, stage or sex classes (e.g., trophy hunting) on population dynamics is relatively well studied in fisheries and sexually dimorphic mammals. 2.?Harvesting of terrestrial species with no morphological differences visible between the different age and sex classes (monomorphic species) is usually assumed to be nonselective because monomorphicity makes intentionally selective harvesting pointless and impractical. But harvesting of the red grouse (Lagopus lagopus scoticus), a monomorphic species, was recently shown to be unintentionally selective. This study uses a sex- and age-specific model to explore the previously unresearched effects of unintentional harvesting selectivity. 3.?We examine the effects of selectivity on red grouse dynamics by considering models with and without selectivity. Our models include territoriality and parasitism, two mechanisms known to be important for grouse dynamics. 4.?We show that the unintentional selectivity of harvesting that occurs in red grouse decreases population yield compared with unselective harvesting at high harvest rates. Selectivity also dramatically increases extinction risk at high harvest rates. 5.?Selective harvesting strengthens the 3- to 13-year red grouse population cycle, suggesting that the selectivity of harvesting is a previously unappreciated factor contributing to the cycle. 6.?The additional extinction risk introduced by harvesting selectivity provides a quantitative justification for typically implemented 20-40% harvest rates, which are below the maximum sustainable yield that could be taken, given the observed population growth rates of red grouse. 7.?This study shows the possible broad importance of investigating in future research whether unintentionally selective harvesting occurs on other species.