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Using validated psychological assessment instruments, this study examined the psychological distress associated with potential language barriers experienced by over 135 000 Puerto Rican residents who either temporarily or permanently migrated to the continental United States with the landfall of Hurricane Maria in 2017.
Participants were Puerto Rican residents (n = 107) who remained in Puerto Rico (control) or left the island for at least 3 months because of Hurricane Maria (migrants). Participants completed an online survey in their preferred language (Spanish or English), which assessed self-reported English language proficiency, Kessler Psychological Distress Scale (K6), Posttraumatic Stress Disorder Checklist for DSM 5, Patient Health Questionnaire 9-item depression scale, and the Generalized Anxiety Disorder 7-item scale. It was hypothesized that migrants with lower self-reported English proficiency would have comparatively higher indices of post-disaster distress than those with a higher proficiency.
Dividing the migrant group by preferred language for questionnaire completion, the Fisher’s exact test showed significant differences in prevalence of severe mental distress, as defined by K6 scores above 13, between the Spanish-preferring migrants (30.4%), English-preferring migrants (0%), and controls (9.6%).
Our results support a possible correlation between decreased language proficiency in post-disaster migrants and a higher risk factor for severe mental distress.
In this work, we study the effect of the compression-corner angle on the streamwise turbulent kinetic energy (sTKE) and structure in Mach 2.8 flow. Krypton tagging velocimetry (KTV) is used to investigate the incoming turbulent boundary layer and flow over
compression corners. The experiments were performed in a 99 %
and 1 % Kr gas mixture in the Arnold Engineering Development Complex (AEDC) Mach 3 Calibration Tunnel (M3CT) at
. A figure of merit is defined as the wall-normal integrated sTKE (
), which is designed to identify turbulence amplification by accounting for the root-mean-squared (r.m.s.) velocity fluctuations and shear-layer width for the different geometries. We observe that the
increases as an exponential with the compression-corner angle near the root when normalized by the boundary-layer value. Additionally, snapshot proper orthogonal decomposition (POD) is applied to the KTV results to investigate the structure of the flow. From the POD results, we extract the dominant flow structures and compare each case by presenting mean-velocity maps that correspond to the largest positive and negative POD mode coefficients. Finally, the POD spectrum reveals an inertial range common to the boundary-layer and each compression-corner flow that is present after the first
dominant POD modes.
To understand caregivers’ perceptions of children’s linear growth and to identify the cultural meanings and perceptions of risk associated with poor height attainment.
Three investigators from Bangladesh conducted twelve focus group discussions.
The study was conducted in rural and slum settings in Bangladesh.
Participants included mothers and alternative caregivers (n 81) who were recruited by household screening. No eligible, recruited subjects refused participation.
Caregivers reported limited experience with growth monitoring services from the health system. Caregivers mainly use visual cues and developmental milestones to understand if children are growing properly, and recognize that children normally experience both weight gain and linear growth with age. Mothers expressed concern over children’s malnutrition and short stature, but did not discuss children’s failure to attain a ‘growth potential’ or distinguish inherited short stature from stunting. Caregivers interpret the consequences of poor height attainment as primarily social and economic and cite few health risks.
Linear growth interpretation is determined more by community norms than by guidance from nutrition programming or the health system. Interventions to prevent or reduce linear growth failure may be perceived to have limited value where appropriate linear growth in children is determined by comparison to peers and siblings. Such perceptions may be significant barriers to programmes addressing stunting prevention in settings where many children are stunted. Efforts to raise awareness about the risks of linear growth faltering may need to consider delivering messages to caregivers that emphasize the social and economic consequences of stunting.
Cellulose nanocrystals (CNCs) are high-strength sustainable nanomaterials, the
incorporation of which to a host polymer matrix can potentially lead to
nanocomposites with superior mechanical properties. However, the mismatch in
surface energy of CNCs and common structural polymers is a challenge that needs
to be overcome to prevent the aggregation of CNCs and ensure the robust
integration of CNCs into a polymer matrix. Herein, we report an approach
involving the functionalization of CNCs with maleated-anhydride polypropylene
(MAPP) through diethylenetriamine (DETA) linkers to significantly enhance the
compatibility between CNCs and polypropylene. Polypropylene/modified CNC
nanocomposites displayed 74% and 76% increase in elastic modulus in comparison
to neat polypropylene and polypropylene/untreated CNC nanocomposites,
respectively. The tensile strength was also higher for nanocomposites with
modified CNC than neat polypropylene, as well as nanocomposites with untreated
CNCs. The tensile strength at 5.5% strain of polypropylene/modified CNC
nanocomposites was 32% and 28% larger that of polypropylene and
polypropylene/untreated CNC nanocomposites, respectively. Finally, such
CNC-based nanocomposites have a lower density than many competitive systems
resulting in opportunities to propagate this environmentally-responsible
technology to nanocomposites used in additive manufacturing, automotive
applications, construction materials and consumer products.
To study (i) the current prevalence of iodine-deficiency disorders among schoolchildren in south-western Saudi Arabia after universal salt iodization and (ii) the iodine content of table salts and water.
Cross-sectional study on a stratified proportional allocation sample of children. Thyroid gland enlargement was assessed clinically and by ultrasound scanning. Urine, table salt and water samples were taken to measure iodine content.
The Aseer region, south-western Saudi Arabia.
Schoolchildren aged 8–10 years.
The study included 3046 schoolchildren. The total goitre rate amounted to 24·0 %. Prevalence of enlarged thyroid by ultrasound was 22·7 %. The median urinary iodine concentration of the study sample amounted to 17·0 µg/l. The iodine content of table salt ranged from 0 to 112 mg/kg; 22·5 % of the table salt samples were below the recommended iodine content (15 mg/kg) set by WHO. The total goitre rate increased significantly from 19·8 % among children using table salt with iodine content ≥15 mg/kg to reach 48·5 % among children using table salt with 0 mg iodine/kg. Analysis of water samples taken from schools showed that the majority of water samples (78·8 %) had an iodine content of 0 µg/l.
The study documented that 18 years after the national study, and after more than a decade of universal salt iodization in Saudi Arabia, the problem of iodine-deficiency disorders is still endemic in the Aseer region. Efforts should focus on fostering advocacy and communication and ensuring the availability of adequately iodized salt.
The presence of the fish species Monocentris japonica is reported from the Iraqi waters of the Arabian Gulf. One adult specimen (125 mm total length) was caught from the waters around the Khor Abdullah within the Iraqi marine territory, giving a new ichthyofaunal record for the area.
We review clinical, neuroimaging, and genetic information on six individuals with isolated sulfite oxidase deficiency (ISOD).
All patients were examined, and clinical records, biochemistry, neuroimaging, and sulfite oxidase gene (SUOX) sequencing were reviewed.
Data was available on six individuals from four nuclear families affected by ISOD. Each individual began to seize within the first week of life. neurologic development was arrested at brainstem reflexes, and severe microcephaly developed rapidly. neuroimaging within days of birth revealed hypoplasia of the cerebellum and corpus callosum and damage to the supratentorial brain looking like severe hypoxic-ischemic injury that evolved into cystic hemispheric white matter changes. Affected individuals all had elevated urinary S-sulfocysteine and normal urinary xanthine and hypoxanthine levels diagnostic of ISOD. Genetic studies confirmed SUOX mutations in four patients.
ISOD impairs systemic sulfite metabolism, and yet this genetic disease affects only the brain with damage that is commonly confused with the clinical and radiologic features of severe hypoxic-ischemic encephalopathy.
In order to understand current and changing patterns of population health, there is a clear need for high-quality health indicators. The World Health Organization Study on Global AGEing and Adult Health (SAGE) survey platform and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries (INDEPTH) generated data for this study. A total of 4300 people aged 50 years or older were selected randomly from the Matlab Health and Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh. The health indicators derived from these survey data are self-rated general health, overall health state, quality of life and disability levels. The outcome of the study is mortality over a 2-year follow-up since the survey. Among the four health indicators, only self-rated health was significantly associated with subsequent mortality irrespective of sex: those who reported bad health had higher mortality than those who reported good health, even after controlling for socio-demographic factors. For all other three health indicators, such associations exist but are significant only for males, while for females it is significant only for ‘quality of life’.
The unsteady laminar boundary layer flow of nanofluid caused by a linearly stretching sheet is considered. Transport equations contain the simultaneous effects of Brownian motion and thermophoretic diffusion of nanoparticles. The relevant partial differential equations are non-dimensionalized and transformed into similar forms by using appropriate similarity transformations. The uniformly valid explicit expressions of velocity, temperature and nanoparticles volume fraction are derived. Convergence of the series solutions is carefully analyzed. It is observed that an increase in the strength of Brownian motion effect rises the temperature appreciably. However rate of heat transfer and nanoparticles concentration at the sheet is reduced when Brownian motion effect intensifies. It is also found that the temperature and nanoparticles concentration are increasing functions of the unsteady parameter.
To determine the optimal cut-offs of BMI for Malaysian adults.
Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors.
All fourteen states in Malaysia.
Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006.
The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23·3 to 24·1 kg/m2 for men and from 24·0 to 25·4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased.
Our findings indicate that BMI cut-offs of 23·0 kg/m2 in men and 24·0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.
This article describes the boundary layer flow and heat transfer in a second grade fluid over a stretching sheet. Heat transfer analysis is carried out in the presence of a Newtonian heating. The partial differential systems have been transformed into the ordinary differential systems by appropriate relations. Homotopy analysis method (HAM) is used for the solutions. Graphical and tabulated results are presented to see the significance of influential parameters on the velocity and temperature fields. It is seen that temperature profiles and heat transfer rate significantly increase by increasing the conjugate parameter (γ) for Newtonian heating.
Introduction: In low-resource communities with long prehospital transport times, most trauma deaths occur outside the hospital. Previous studies from Iraq demonstrate that a two-tier network of rural paramedics with village-based first helpers reduces mortality in land mine and war-injured from 40% to 10%. However, these studies of prehospital trauma care in low-income countries have been conducted with historical controls, thus the results may be unreliable due to differences in study contexts. The aim of this study was to use a controlled study design to examine the effect of a two-tier prehospital rural trauma system on road traffic accident trauma mortality.
Methods: A single referral surgical hospital was the endpoint in a single-blinded, non-randomized cohort study. The catchment areas consisted of some districts with no formal Emergency Medical Services (EMS) system, and other districts where 95 health center paramedics had been trained and equipped to provide advanced life support, and 5,000 laypersons had been trained to give on-site first aid. The hospital staff registered trauma mortality and on-admission physiological severity blindly. Assuming that prehospital care would have no significant impact on mortality in moderate injuries, only road traffic accident (RTA) casualties with an Injury Severity Score (ISS) ≥9 were selected for study.
Results: During a three-month study period, 205 patients were selected for study (128 in the treatment group and 77 in the control group). The mean prehospital transit time was approximately two hours. The two groups were comparable with regards to demographic characteristics, distribution of wounds and injuries, and mean anatomical severity. The mortality rate was eight percent in the treatment group, compared to 44% in the control group (95% CI, 25%–48%). Adjusted for severity differences between the treatment and control groups, prehospital care was a significant contributor to survival.
Conclusion: Where prehospital transport time is long, a two-tier prehospital system of trained paramedics and layperson first responders reduces trauma mortality in severe RTA injuries. The findings may be valid for civilian Emergency Medical Services interventions in other low-resource countries.
Dietary determinants of adolescent blood pressure (BP) are poorly understood. The goal of the present study was to assess the effects of an eating pattern similar to that from the Dietary Approaches to Stop Hypertension (DASH) study on adolescent BP. Data from 2185 girls followed-up over 10 years (until the girls were 18–20 years of age) in the National Heart Lung and Blood Institute's Growth and Health Study were used in this analysis. Diet was assessed during eight examination cycles using 3 d dietary records; girls were classified according to their consumption of foods associated with a DASH-style eating pattern. Analysis of covariance modelling, multiple logistic regression and longitudinal mixed models were used to control for potential confounding by age, race, socio-economic status, height, physical activity, television viewing time and other dietary factors. Girls who consumed ≥ 2 daily servings of dairy and ≥ 3 servings of fruits and vegetables (FV) had a 36 % lower risk (95 % CI: 0·43, 0·97) of elevated BP (EBP) in late adolescence. In longitudinal modelling, two dietary factors were associated with a lower systolic BP throughout adolescence: higher ( ≥ 2 daily servings) dairy intakes (P < 0·0001) and a DASH-style pattern (P = 0·0002). Only the DASH-style pattern led to consistently lower diastolic BP levels (P = 0·0484). Adjustment for BMI did not appreciably modify the results. In this study, adolescent girls whose diets were rich in dairy products and FV during the early- and mid-adolescent years were less likely to have EBP levels in later adolescence.
Group III-nitride compound semiconductors (e.g. AlN-GaN-InN) have generated considerable interest for use in advanced optoelectronic device structures. The fabrication of multi-tandem solar cells, high-speed optoelectronics and solid state lasers operating at higher energy wavelengths will be made possible using (Ga1-y-xAlyInx)N heterostructures due to their robustness against radiation and the wide spectral application range. To date, the growth of indium rich (In1-xGax)N films and heterostructures remains a challenge, primarily due to the large thermal decomposition pressures in indium rich group III-nitride alloys at the optimum growth temperatures. In order to control the partial pressures during the growth process of InN and related alloys, a unique high-pressure chemical vapor deposition (HPCVD) system with integrated real-time optical monitoring capabilities has been developed. We report initial results on InN layers grown at temperatures as high as ∼850°C with reactor pressures around 15 bar. Such process conditions are a major step towards the fabrication of indium rich group III-nitride heterostructures that are embedded in wide band gap group III-nitrides. Real-time optical characterization techniques are applied in order to study the gas phase kinetics and surface chemistry processes during the growth process.
For an ammonia to TMI precursor flow ratio below 500, multiple phases with sharp XRD features are observed. Structural analysis perform by Raman scattering techniques indicates that the E2 high mode improves as NH3:TMI ratio is decreased to below 500. Optical characterization of these InN layers indicates that the absorption edge shifts from down from 1.85 eV to 0.7 eV. This shift seems to be caused by a series of localized absorption centers that appear as the indium to nitrogen stoichiometry varies. This contribution will correlate the process parameters to results obtained by XRD, Raman spectroscopy and optical spectroscopy, in order to assess the InN film properties.