Using Community-Based Participatory Research to Explore Backyard Gardening Practices and Soil Lead Concentrations in Urban Neighborhoods.

BACKGROUND: Lead exposure is a serious health threat for children. Soil is an important exposure pathway, primarily through ingestion and inhalation. Urban agriculture is increasing. Potential environmental health risks associated with residential gardening may not be well known to community residents. OBJECTIVES: A community-based participatory research (CBPR) approach was implemented to explore the relationship between urban residential vegetable gardening and lead exposure in children. The primary objectives were to characterize local backyard vegetable gardening practices, measure residential and commercial soil lead concentrations and spatial distributions, and identify priorities for individual and collective action. METHODS: Participants were recruited in two stages. In phase 1, adult gardeners participated in structured interviews. In phase 2, a multistage representative sampling approach was implemented to recruit adult gardeners for interviews and soil testing. RESULTS: Twenty adults participated in gardening practice interviews. Adults perceive many benefits from backyard gardening and initially expressed few concerns about lead exposure risk. Results indicate that children are actively involved in backyard gardening. Total soil lead concentrations from 17 residential properties ranged from 7 to 3,234 mg kg-1(median, 187; mean, 432). Commercial soils had lead concentrations that ranged from 6 to 13 mg kg(-1) (median, 6.5; mean, 7.6). Nonparametric Mann-Whitney comparisons indicated a significant difference in lead concentration between commercial soil and residential soil (p<0.0001). CONCLUSIONS: Advocacy for resources needed to eliminate dangerous levels of lead from the environment, especially in communities where divestment has occurred, is enhanced through CBPR. Increasing access to soil testing is an important action step.

Egg baked in product open oral food challenges are safe in selected egg-allergic patients.

Egg allergy is one of the most common food allergies in children. Most egg-allergic children are able to tolerate egg baked in product (EBP) and will likely outgrow his/her egg allergy. By introducing EBP in the diet of an egg-allergic child, diet can be expanded and family stress can be reduced. Recent evidence suggests that children who tolerate EBP and continue to consume it will have quicker resolution of egg allergy than those who strictly avoid EBP; therefore, we aimed to evaluate the egg-allergic children who underwent EBP oral food challenge (OFC) in our allergy clinic to help define any specific predictors to be used in predicting the outcome of such challenges. We performed a retrospective chart review and 43 egg-allergic patients underwent EBP OFC in our outpatient allergy office from January 2011 to December 2012 were excluded. Nine patients who did not have a prior history of symptomatic egg ingestion. Clinical characteristics and laboratory findings of the remaining 34 patients were all recorded and analyzed. Of the remaining 34 patients, 22 (64.7%) were boys. Average age of first reaction to egg was 12.90 months, with average age at EBP OFC of 71.32 months. The average of the most recent skin-prick test wheal size was 10.10 mm and serum-specific IgE to egg white was 3.21 kU/L. Twenty-eight of the 34 patients (82.4%) passed the EBP OFC. Of the six patients who failed, none required epinephrine. After analysis of all of the clinical characteristics and laboratory findings, no risk factors, such as skin-prick test wheal size, were identified to be associated with an increased risk of failing EBP OFC. EBP OFC is a valuable tool to assess tolerance. As seen in our group of patients, the majority of egg-allergic patients pass EBP OFC. Thus, OFC should be considered as a clinical tool to expand a patient's diet and to improve quality of life as early as possible. Because we were unable to determine any clinical or laboratory predictors helpful to select egg-allergic patients who are likely to pass EBP OFC, additional prospective studies are necessary to determine the ideal egg-allergic patient who is likely to pass EBP OFC.

Multiple neuronal networks mediate sustained attention.

Sustained attention deficits occur in several neuropsychiatric disorders. However, the underlying neurobiological mechanisms are still incompletely understood. To that end, functional MRI was used to investigate the neural substrates of sustained attention (vigilance) using the rapid visual information processing (RVIP) task in 25 healthy volunteers. In order to better understand the neural networks underlying attentional abilities, brain regions where task-induced activation correlated with task performance were identified. Performance of the RVIP task activated a network of frontal, parietal, occipital, thalamic, and cerebellar regions. Deactivation during task performance was seen in the anterior and posterior cingulate, insula, and the left temporal and parahippocampal gyrus. Good task performance, as defined by better detection of target stimuli, was correlated with enhanced activation in predominantly right fronto-parietal regions and with decreased activation in predominantly left temporo-limbic and cingulate areas. Factor analysis revealed that these performance-correlated regions were grouped into two separate networks comprised of positively activated and negatively activated intercorrelated regions. Poor performers failed to significantly activate or deactivate these networks, whereas good performers either activated the positive or deactivated the negative network, or did both. The fact that both increased activation of task-specific areas and increased deactivation of task-irrelevant areas mediate cognitive functions underlying good RVIP task performance suggests two independent circuits, presumably reflecting different cognitive strategies, can be recruited to perform this vigilance task.