A call from 40 public health scientists for an end to the continuing humanitarian and environmental catastrophe in Gaza.

An under-recognised aspect of the current humanitarian catastrophe in Gaza is the impact of the war on the environment and the associated risks for human health. This commentary contextualises these impacts against the background of human suffering produced by the overwhelming violence associated with the use of military force against the general population of Gaza. In calling for an immediate cessation to the violence, the authors draw attention to the urgent need to rebuild the health care system and restore the physical and human infrastructure that makes a liveable environment possible and promotes human health and well-being, especially for the most vulnerable in the population. Environmental remediation should therefore form one of the most important parts of international efforts to assist reconstruction, through which we hope Palestinians and Israelis will achieve lasting peace, health, and sustainable development, all as part of accepted international human rights obligations.

Wild fish consumption and latitude as drivers of vitamin D status among Inuit living in Nunavik, northern Québec.

OBJECTIVE: To measure vitamin D status and estimate factors associated with serum 25-hydroxyvitamin D (25(OH)D) in Nunavimmiut (Inuit living in Nunavik) adults in 2017. DESIGN: Data were from Qanuilirpitaa? 2017 Nunavik Inuit Health Survey, a cross-sectional study conducted in August-October 2017. Participants underwent a questionnaire, including an FFQ, and blood samples were analysed for total serum 25(OH)D. SETTING: Nunavik, northern Québec, Canada. PARTICIPANTS: A stratified proportional model was used to select respondents, including 1,155 who identified as Inuit and had complete data. RESULTS: Geometric mean serum vitamin D levels were 65·2 nmol/l (95 % CI 62·9-67·6 nmol/l) among women and 65·4 nmol/l (95 % CI 62·3-68·7 nmol/l) among men. The weighted prevalence of serum 25(OH)D < 75 nmol/l, <50 nmol/l <30 nmol/l was 61·2 %, 30·3 % and 7·0 %, respectively. Individuals who were older, female, lived in smaller and/or more southerly communities and/or consumed more country (traditional) foods were at a reduced risk of low vitamin D status. Higher consumption of wild fish was specifically associated with increased serum 25(OH)D concentration. CONCLUSION: It is important that national, regional and local policies and programs are in place to secure harvest, sharing and consumption of nutritious and culturally important country foods like Arctic char and other wild fish species, particularly considering ongoing climate change in the Arctic which impacts the availability, access and quality of fish as food.

Mapping Potential Population-Level Pesticide Exposures in Ecuador Using a Modular and Scalable Geospatial Strategy.

Human populations and ecosystems are extensively exposed to pesticides. Most nations lack the capacity to control pesticide contamination and have limited availability of pesticide use information. Ecuador is a country with intense pesticide use with high exposure risks to humans and the environment, although relative or combined risks are not well understood. Here, we analyzed the distribution of application rates in Ecuador and identified regions of concern because of high potential exposure. We used a geospatial analysis to identify grid cells (∼8 km × 8 km) where the highest pesticide application rates and density of human populations overlap. Furthermore, we identified other regions of concern based on the number of amphibian species as an indicator of ecosystem integrity and the location of natural protected areas. We found that 28% of Ecuador's population dwelled in areas with high pesticide application rate. We identified an area of ∼512 km2 in the Amazon region where high application rates, large human settlements, and a high number of amphibian species overlapped. Additionally, we distinguished clusters of pesticide application rates and human populations that intersected with natural protected areas. Ecuador exemplifies how pesticides are disproportionately applied in areas with the potential to affect human health and ecosystems' integrity. Global estimates of population dwelling, pesticide application rates, and environmental factors are key in prioritizing locations to conduct further exposure assessments. The modular and scalable nature of the geospatial tools we developed can be expanded and adapted to other regions of the world where data on pesticide use are limited.

Unwanted or Mistimed Pregnancy and Developmental Issues in Ecuadorian Children Aged 3 to 5: A Doubly Robust Estimate Using Data from the National Health and Nutrition Survey 2018.

BACKGROUND: Past studies in high-income countries have shown an association between unintended (unwanted or mistimed) pregnancy and child development; no national-level studies in low-and-middle-income countries have been conducted. Moreover, extant studies often adjust for potential mediators, underestimating the average population effect. METHODS: We aimed to estimate the effect of unintended pregnancy on early childhood development in Ecuadorian children aged 3 to 5, participating in the National Health and Nutrition Survey 2018. We used a design-based doubly robust estimate. First, we used propensity score matching (1:1) to identify a subsample equally likely to come from a desired vs. unintended pregnancy based on geographic area, household income, paternal intendedness, the mother's current marital status, age, ethnicity, and educational level, depressive symptoms, and the child's gender and age. Then, we used a logistic regression model to explore the relation of maternal pregnancy intentions with adequate development, as defined by the Early Childhood Development Index (ECDI). While exempt from review by an Institutional Review Board, this secondary research was conducted in accord with prevailing ethical principles. RESULTS: Among 1694 observations representing 162,285 Ecuadorian children, unintended pregnancy associated with inadequate development (odds ratio: 1.56; 95% confidence interval: 1.06; 2.29), after adjusting for all relevant confounders. Unintended pregnancy was also negatively associated with all four ECDI domains, socio-emotional development being the most affected. DISCUSSION: Our doubly robust design found evidence of the relation between the maternal perception of pregnancy and early child development. Addressing this relation to achieve reproductive justice entails considering a wide spectrum of population health and legal interventions to allow adequate access to education, contraception, and safe abortion. Moreover, pre- and post-natal check-ups could screen for unintended pregnancy and provide support accordingly.

What is already known on this subject? Studies from developed countries have shown an association between unintended pregnancy and early child development. Such contexts are not transferable to developing economies and cultures.What this study adds? Using a doubly robust estimate and avoiding known mediators, we provide the first national-level average population effect estimation of unintended pregnancy on child development from low-and-middle-income countries. Ecuadorian children born from unintended pregnancies had a 42% increased risk of having inadequate development, as measured by the Early Childhood Development Index (ECDI), at ages 3 to 5 compared to wanted children. Inadequate development was found in each of the ECDI domains: numeracy and literacy, social-emotional development, physical development, and approaches to learning.

Multioctave supercontinuum generation and frequency conversion based on rotational nonlinearity.

The field of attosecond science was first enabled by nonlinear compression of intense laser pulses to a duration below two optical cycles. Twenty years later, creating such short pulses still requires state-of-the-art few-cycle laser amplifiers to most efficiently exploit "instantaneous" optical nonlinearities in noble gases for spectral broadening and parametric frequency conversion. Here, we show that nonlinear compression can be much more efficient when driven in molecular gases by pulses substantially longer than a few cycles because of enhanced optical nonlinearity associated with rotational alignment. We use 80-cycle pulses from an industrial-grade laser amplifier to simultaneously drive molecular alignment and supercontinuum generation in a gas-filled capillary, producing more than two octaves of coherent bandwidth and achieving >45-fold compression to a duration of 1.6 cycles. As the enhanced nonlinearity is linked to rotational motion, the dynamics can be exploited for long-wavelength frequency conversion and compressing picosecond lasers.

Scoping Review and Bibliometric Analysis of the Term "Planetary Health" in the Peer-Reviewed Literature.

Background: Planetary health is an emerging holistic health field to foster interdisciplinary collaborations, integrate Indigenous knowledge, facilitate education, and drive public and policy engagement. To understand to what extent the field has successfully met these goals, we conducted a scoping review and bibliometric analysis. Methods: We searched 15 databases from 2005 to 2019 for peer-reviewed publications with the term "planetary health" in the title, abstract and/or keywords, with no language or geographical location limitations. We classified results into four categories (commentaries, comprehensive syntheses, educational material, and original research) and categorized original research according to expert-derived planetary health themes. Our bibliometric analysis highlighted publications over time, collaborations, and networks of keywords. Findings: Only 8.1% (n = 22) were research articles. Publications rose rapidly from 8 to 64 publications per year in 2015-2018. The top five author affiliation countries for most publications were the US, UK, Australia, Canada, and New Zealand, and the top five collaborations were a subset of pairwise combinations between the US, UK, Australia, and Canada. The most common author keywords were the following: planetary health, climate change, ecology, and non-communicable diseases. Keyword co-occurrences clustered around high-level concepts (e.g., Anthropocene) and food system-related topics; two clusters lacked a theme. Interpretation: We show that the term planetary health is used mainly in commentary-like publications, not original research. Additionally, more global collaborations are lacking. Interdisciplinary work, as represented by keyword co-occurrence networks, is developing but could potentially be extended. The planetary health community should promote more worldwide research and interdisciplinary collaborations.

Results Communication in Breast Milk Biomonitoring Studies: A Scoping Review and Stakeholder Consultation.

Researchers investigating breast milk contamination face substantive ethical dilemmas regarding how biomonitoring results should be conveyed, with limited guidance available to help them. To identify effective processes for undertaking such research, we sought to critically assess practices being followed in reporting results. To consider how researchers have reported on this and related ethical issues, we searched three English-language databases for articles published between 2010-2016 on measuring presence of pesticides in breast milk. Data on report-back processes and discussed ethical issues were charted from retained articles (n=102). To deepen our understanding of issues, we further consulted authors (n=20) of retained articles through an online survey. Quantitative data from surveys were tabulated and qualitative data were analyzed thematically. Of 102 articles, only two mentioned sharing results with subjects, while 10 out of 20 survey participants confirmed that they had indeed conducted report-back in their studies. Articles discussing ethical considerations were few (n=5), although researchers demonstrated awareness of common ethical debates to inform report-back decisions. Our review suggests that greater explicit attention should be given to practices of engaging study subjects and their communities in contamination studies so that an evidence base on best ethical practices can be more readily available.

Chemical exposure reduction: Factors impacting on South African herbicide sprayers' personal protective equipment compliance and high risk work practices.

The high exposure risks of workers to herbicides in low- and middle-income countries is an important public health concern because of the potential resulting negative impacts on workers' health. This study investigated workers' personal protective equipment (PPE) compliance as a risk mitigation measure; particularly workers who apply herbicides for Working for Water (WfW) - a South African invasive alien vegetation control programme. The study aim was to understand workers' low PPE compliance by analysing their risk perceptions of herbicide use, working conditions and socio-cultural context. Research methods included ethnographic observations, informal interviews, visual media, questionnaires and a focus group. Study results indicated that low PPE compliance persists despite workers' awareness of herbicide exposure risks and as a result of the influence from workers' socio-cultural context (i.e. gender dynamics and social status), herbicide risk perceptions and working conditions (i.e. environmental and logistical). Interestingly, teams comprised of mostly women had the highest compliance rate. These findings highlighted that given the complexity of PPE compliance, especially in countries with several economic and social constraints, exposure reduction interventions should not rely solely on PPE use promotion. Instead, other control strategies requiring less worker input for effectiveness should be implemented, such as elimination and substitution of highly hazardous pesticides, and altering application methods.

Acceso a servicios de salud: análisis de barreras y estrategias en el caso de Medellín, Colombia / Access to Health Services: Analysis of Barriers and Strategies in Medellín, Colombia / Acesso aos servidos de saúde: análise de barreiras e estrategias no caso de Medellín, Colombia

Contexto: el acceso a servicios de salud es un tema de creciente preocupación, en el caso colombiano ha ganado importancia frente al aseguramiento. Objetivo: construir un concepto de acceso e identificar barreras y estrategias, desde la perspectiva de actores en Medellín. Material y métodos: investigación cualitativa con énfasis en tres zonas de Medellín. Resultados: se identificaron similitudes y diferencias en la visión del acceso, las cuales permitieron construir el concepto. Las barreras y los facilitadores se atribuyen a factores de oferta y de demanda. La mayoría de las barreras se dan en el acceso real, durante la búsqueda y continuidad del tratamiento. Algunas características sociales de la población también son factores determinantes. Discusión y conclusiones: los actores recurren a estrategias para solventar las barreras de acceso. El análisis cualitativo del concepto de acceso, de las barreras y las facilidades permite identificar alternativas que pueden servir de insumo para políticas en salud.

Context: The access to health services is an increasingly worrying topic in the research and public policies agendas. In the case of Colombia, this topic becomes more important and attains supremacy opposite to assurance. Objective: Building a concept of access and identifying barriers, as well as strategies and alternatives to overcome them from the perspective of the actors of the health system in Medellin. Materials and Methods: qualitative research, focused on three areas of Medellin. We used techniques such as semi-structured interviews; social cartography workshops; observation and result questionnaires of the services. Results: The vision on the access is heterogeneous between actors, although some similarities and differences were identified, that allowed us to build a proposal of the concept of access. The barriers and factors that facilitate access can be attributed to factors on the offer side as well as on the demand side. Most of the barriers happen during real access, during the search and continuity of the treatment. The social characteristics of the population, such as knowledge of the system and social and community support are also determinant factors of access. Discussion and Conclusions: All actors use strategies to solve the access barriers and are affected by them on different levels. The qualitative analysis of the concept of access, of barriers and facilities, allow the identification of alternatives that may serve as components for health policies.

Contexto: O acesso aos serviços de saúde é tema de preocupação crescente nas agendas de pesquisa e as políticas públicas. No caso colombiano, a questão ganha importància e encontra uma supremacia frente à asseguração. Objetivo: construir um conceito de acesso e identificar barreiras, estratégias e alternativas para superá-las, desde a perspectiva dos atores do sistema de saúde na cidade de Medellín. Material e métodos: pesquisa qualitativa, com ènfase em très zonas de Medellín. Utilizaram-se técnicas como entrevistas semiestruturadas, oficinas de cartografia social, observação e questionários de saída dos serviços. Resultados: a visáo sobre o acesso é heterogénea entre atores, embora foram identificadas similitudes e diferencas que permitiram construir uma proposta de conceito de acesso. As barreiras e fatores que facilitam o acesso sáo atribuíveis a fatores tanto do lado da oferta quanto do lado da demanda. A maioria das barreiras ocorrem no acesso real, durante a procura e continuidade do tratamento. Características sociais da populacáo, como conhecimento do sistema e apoio social e comunitàrio, sáo também fatores determinantes do acesso. Discussao e conclusoes: todos os atores recorrem a estratégias para superar as barreiras de acesso e sáo afetados por estas em níveis diferentes. A análise qualitativa do conceito de acesso, das barreiras e as facilidades permite identificar alternativas que podem servir de insumo para políticas em saúde.

Extracellular enzymes produced by microorganisms isolated from maritime Antarctica.

Antarctic environments can sustain a great diversity of well-adapted microorganisms known as psychrophiles or psychrotrophs. The potential of these microorganisms as a resource of enzymes able to maintain their activity and stability at low temperature for technological applications has stimulated interest in exploration and isolation of microbes from this extreme environment. Enzymes produced by these organisms have a considerable potential for technological applications because they are known to have higher enzymatic activities at lower temperatures than their mesophilic and thermophilic counterparts. A total of 518 Antarctic microorganisms, were isolated during Antarctic expeditions organized by the Instituto Antártico Uruguayo. Samples of particules suspended in air, ice, sea and freshwater, soil, sediment, bird and marine animal faeces, dead animals, algae, plants, rocks and microbial mats were collected from different sites in maritime Antarctica. We report enzymatic activities present in 161 microorganisms (120 bacteria, 31 yeasts and 10 filamentous fungi) isolated from these locations. Enzymatic performance was evaluated at 4 and 20°C. Most of yeasts and bacteria grew better at 20°C than at 4°C, however the opposite was observed with the fungi. Amylase, lipase and protease activities were frequently found in bacterial strains. Yeasts and fungal isolates typically exhibited lipase, celullase and gelatinase activities. Bacterial isolates with highest enzymatic activities were identified by 16S rDNA sequence analysis as Pseudomonas spp., Psychrobacter sp., Arthrobacter spp., Bacillus sp. and Carnobacterium sp. Yeasts and fungal strains, with multiple enzymatic activities, belonged to Cryptococcus victoriae, Trichosporon pullulans and Geomyces pannorum.

Deoxynivalenol in barley samples from Uruguay.

A survey of the natural occurrence of deoxynivalenol (DON) in barley harvested in Uruguay from 1996 to 2002 was conducted. A total of 292 samples were analyzed for DON by an immunochemical method using inmunoaffinity columns and fluorimetric detection. Between 26 and 100% of the samples were positive for DON while mean DON contents varied between the quantification limit (500 mug/kg) to 6349 mug/kg. Annual maximum levels in individual samples ranged from 1900 mug/kg to 10,000 mug/kg. The mean DON contents were similar from 1996 to 1999 increasing markedly from 2000 to 2002. The percentage of the samples with DON were highest in 1997, 2000, 2001 and 2002 (67, 90, 100 and 100%) as was the accumulated precipitation during the flowering period. A positive correlation between DON levels and precipitation was seen. These results suggest that monitoring for DON barley crops, particularly in years with heavy rainfall during the flowering period, must be regularly performed.