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Due to its severity, the COVID-19 pandemic is one of the greatest crises to have tested the European Union’s (EU) ability to take effective action. The restrictive measures adopted by the Member States to curb its spread affected in particular the free movement of people and partly of goods. This prompted the EU to take action inter alia to maintain essential travel, protect supply chains, enhance contact tracing and facilitate the coordinated resumption of travel. Building on the notion of “output legitimacy”, this paper assesses the EU’s success in responding to the COVID-19 pandemic in transport by looking at the four main initiatives between the end of 2020 and June 2022, namely: (1) the EU Digital COVID Certificates; (2) cross-border contact tracing through Passenger Locator Forms; (3) the “Green Lanes” for freight transport; and (4) the coordinated approach to facilitating safe and free movement. These initiatives are measured against the EU’s legal competence, economic interests, political pressure and the added value of EU action. While recognising the small set of cases, the results show that, although legal competence is a decisive factor for success, EU initiatives can achieve equivalent effect even in its absence, provided other conditions are met.
High burden of anaemia exists amongst rural adolescent girls in India. The objective of this study was to characterise anaemia in school going adolescent girls in rural Haryana, India.
Linear and multiple logistic regression analysis of data collected prior to an intervention trial was conducted. Participants were classified into anaemic (haemoglobin <12 g/dl) and non-anaemic group and were further classified into deficiencies of Fe, folate or vitamin B12, mixed, anaemia of other causes and inflammation.
Three schools in Ballabgarh block of Faridabad District, Haryana, India.
One hundered and ninety-eight non-anaemic and 202 anaemic adolescent girls (12–19 years).
Anaemic girls had 29·6 % Fe deficiency, 28·1 % folate or vitamin B12 deficiency, 15·8 % mixed deficiency and 9·7 % acute inflammation. Anaemia of other causes was found in 16·8 % of the anaemic participants. Girls with Fe and isolated folate deficiency had 2·5 times and four times higher odds of developing anaemia, respectively, as compared with non-anaemic girls. Fe deficiency with no anaemia was found amongst 11 % non-anaemic girls. Non-anaemic girls had a high prevalence of combined deficiency of folate or vitamin B12 (29·5 %) and acute inflammation (14·4 %).
The current strategy of Fe and folic acid supplementation alone will not suffice for achieving the desired reduction in the prevalence of anaemia as unknown causes and anaemia of inflammation contribute to a substantial proportion of anaemia. Integrating other nutrition-specific components like improving water, sanitation and hygiene practices with the ongoing micronutrient supplementation program will comprehensively tackle anaemia. Unknown causes of anaemia warrant further research.
Cardiac hypertrophy (CH) is an augmentation of either the right ventricular or the left ventricular mass in order to compensate for the increase of work load on the heart. Metabolic abnormalities lead to histological changes of cardiac myocytes and turn into CH. The molecular mechanisms that lead to initiate CH have been of widespread concern, hence the development of the new field of research, metabolomics: one ‘omics’ approach that can reveal comprehensive information of the paradigm shift of metabolic pathways network in contrast to individual enzymatic reaction-based metabolites, have attempted and until now only 19 studies have been conducted using experimental animal and human specimens. Nuclear magnetic resonance spectroscopy and mass spectrometry-based metabolomics studies have found that CH is a metabolic disease and is mainly linked to the harmonic imbalance of glycolysis, citric acid cycle, amino acids and lipid metabolism. The current review will summarise the main outcomes of the above mentioned 19 studies that have expanded our understanding of the molecular mechanisms that may lead to CH and eventually to heart failure.
Lanthanum zirconate (La2Zr2O7) nano-crystalline films with cubic structure have been successfully prepared by a facile synthesis approach called reactive spray deposition technology (RSDT). La2Zr2O7 nanoparticles are produced by combusting a precursor solution of lanthanum acetylacetonate hydrate and zirconium acetylacetonate dissolved in an organic solvent mixture. The nanoparticles formed during the combustion process are directly deposited onto the substrate. The composition and microstructure of the as-deposited films are extensively characterized by X-ray diffraction (XRD), scanning electron microscope (SEM) and transmission electron microscope (TEM). The thermal diffusivities of the films are investigated by the means of laser flash method.
Assess Hurricane Sandy’s impact on primary care providers’ services in the Rockaways.
In-person surveys were conducted in 2014. A list of 46 health care sites in the area of interest was compiled and each site was called to offer participation in our survey. Respondents included physicians and practice administrators who remained familiar with Sandy-related operational challenges.
Of the 40 sites that opted in, most had been in their current location for more than 10 years (73%) and were a small practice (1 or 2 physicians) before Hurricane Sandy (75%). All but 2 (95%) had to temporarily close or relocate. All sites experienced electrical problems that impacted landline, fax, and Internet. Less than one-quarter (n = 9) reported having a plan for continuity of services before Hurricane Sandy, and 43% reported having a plan poststorm. The majority (80%) did not report coordinating with other primary care stakeholders or receiving support from government agencies during the Sandy response.
Hurricane Sandy significantly disrupted access to primary care in the Rockaways. Severe impact to site operations and infrastructure forced many practices to relocate. Greater emergency response and recovery planning is needed, including with government agencies, to minimize disruptions of access to primary care during disaster recovery. (Disaster Med Public Health Preparedness. 2016;10:492–495)
Hurricane Sandy in the Rockaways, Queens, forced residents to evacuate and primary care providers to close or curtail operations. A large deficit in primary care access was apparent in the immediate aftermath of the storm. Our objective was to build a computational model to aid responders in planning to situate primary care services in a disaster-affected area.
Using an agent-based modeling platform, HAZEL, we simulated the Rockaways population, its evacuation behavior, and primary care providers’ availability in the aftermath of Hurricane Sandy. Data sources for this model included post-storm and community health surveys from New York City, a survey of the Rockaways primary care providers, and research literature. The model then tested geospatially specific interventions to address storm-related access deficits.
The model revealed that areas of high primary care access deficit were concentrated in the eastern part of the Rockaways. Placing mobile health clinics in the most populous census tracts reduced the access deficit significantly, whereas increasing providers’ capacity by 50% reduced the deficit to a lesser degree.
An agent-based model may be a useful tool to have in place so that policy makers can conduct scenario-based analyses to plan interventions optimally in the event of a disaster. (Disaster Med Public Health Preparedness. 2016;10:386–393)
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