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Global Comparison Of Children’s Exposomes
Full text linkEnvironmental influences impact health, often with enhanced susceptibility for theyoung. Understanding the sources of these environmental factors is critical for mitigating exposures. Globally, children are exposed to many sources that differ by policy, urbanization, and socioeconomic conditions. Specifically, urbanization creates variation in exposure sources that differ in rural (refuse combustion, cooking biomass combustion, indoor residual spray) and urban areas (vehicle combustion, industrial activity). Differences in policy further shape these exposure patterns by regulating pollution sources, chemical use, and environmental protections across countries. This thesis evaluated environmental exposures of children living in United States, South Africa, and Singapore contributing to a broader understanding of children’s exposomes. The Fresh Air Wristband, a passive wearable sampler, was used to characterize the exposome of 538 children from five cohorts. Eighty-six children resided in New Haven, CT, and Boston, MA; 301 children from Singapore; and 151 children from the Limpopo province of South Africa. This study utilizes ongoing research from the (1) Short-Term Longitudinal Study of the Brain Mechanisms of Childhood Irritability (fMRI), (2) Very Early Onset Inflammatory Bowel Disease (VEOIBD): Precision Molecular Diagnoses to Targeted Therapies study, (3) Venda Health Examination of Mothers, Babies, and their Environment (VHEMBE) study, (4) Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study, and (5) Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) study. Using the Fresh Air Wristbands, 68 chemicals were detected across cohorts, including phthalates, polycyclic aromatic hydrocarbons (PAHs), and organochlorine pesticides (OCPs). Across all cohorts, 12 compounds were detected with a detection frequency greater than 50%. Higher concentrations of ii PAHs and phthalates were found in both the South Africa and Singapore cohorts compared to the United States cohort (FDR adjusted p value \u3c0.05). Age-related variation in exposure was further analyzed by cohort. In the Singapore cohort, exposure profiles were consistent despite the wide range in participant age (4-to 6-year- olds compared to 13- to 14-year-olds). The United States cohort exhibited notable age-related differences in exposure, with high variation observed between younger (8 to 13 years old) and older (primarily 10 to 18 years old)(FDR adjusted p value \u3c0.05). Additionally, a brief analysis of environmental and chemical regulatory policies was conducted focusing on organochlorine pesticides (OCPs), flame retardants and phthalates. Phthalates, particularly those associated with plastics, were more consistently detected across the cohorts and presented differences in policy, especially regarding waste management. Both OCPs and flame retardants had detection frequencies below 50%, but the comparison across cohort provided additional insight into policy-related differences in exposure. This study explored cross-country differences in children’s exposomes and assessed the impact of geographical variation in exposure profiles, emphasizing how children’s exposures are shaped by geographic differences
Quantifying Ambient And Occupational Pollutant Exposure In Urban Street Vendors: Evidence To Inform Electrification Transitions In New York City
Full text linkFood cart vendors in New York City face significant environmental health risks from exposure to extreme heat and air pollution, compounded by their reliance on fossil fuel-powered generators. Despite growing interest in electrification as a cleaner alternative, limited research has explored vendors\u27 experiences with generator use, health concerns, and attitudes toward electrification. This study, conducted in collaboration with the Yale School of Public Health and the New York City Mayor’s Office of Climate & Environmental Justice (MOCEJ), used a mixed-methods approach to assess vendor conditions and perspectives. Data were collected from 31 vendors across four NYC locations through structured interviews (qualitative) and environmental monitoring of air quality, temperature, and noise (quantitative). Quantitative findings revealed elevated heat exposure and high noise levels from generator use, while qualitative results highlighted vendors’ concerns about health risks and their conditional support for electrification, depending on affordability and performance. This study emphasizes the importance of integrating vendor voices into policy, assessing the technical feasibility of technology, and further investigating the health risks from both cart infrastructure and cooking equipment
Providing Safe Gastric Feedings In Pediatric Patients On High Flow Nasal Cannula Respiratory Support
Full text linkPurpose: HFNC is used to manage pediatric respiratory distress, but concerns aboutgastric air insufflation and aspiration risk lead to delayed feedings. There is no standardized practice guiding gastric feedings in children on HFNC. This project developed and implemented a decision tree to guide clinical decision-making for gastric feedings for children on HFNC. Methods: A HFNC feeding safety decision tree was developed following literature review and implemented in a Pediatric Intensive Care Unit (PICU). The primary outcome evaluated HFNC flow rates when starting gastric feeds. Secondary outcomes include adverse events (AEs), physiologic distress, and PICU/hospital LOS. Data were analyzed using Chi-Square test with Fisher’s Exact Test for categorical variables and Kruskal Wallis for continuous variables. Results: After implementation, feeds were started at higher HFNC flow rates, with a median of 10 liters per minute (LPM) (IQR 10-12) compared to a median of 8 LPM (IQR 6-10), p = 0.007. Even with gastric feeding initiation at higher flow rates post-intervention, there were no AEs, no statistical differences in vital signs before or after feeds, and no reduction in PICU/hospital LOS. However, duration on HFNC was longer post-implementation (p = 0.034). Conclusions: The decision tree led to earlier initiation of gastric feeds without AEs or changes in vital signs, indicating nutrition can be safely provided at higher HFNC flow rates. Further analysis with a larger cohort is needed to assess whether earlier gastric feeds could reduce LOS, and if it is affected by key covariates (e.g. age or diagnosis)
Implementing A Screening Algorithm For Depression Diagnosis, Management And Referrals In Primary Care
Full text linkDepression is a major cause of mortality, morbidity, disability, and economic costs in theUnited States. Everyday millions of Americans navigate our complex healthcare field to find the best solution to their problem. Due to a shortage of specialized psychiatric providers, often these people must rely on the primary care settings to get the help they need. However, the lack of knowledge in screening and management of mood disorders causes many of these patients to fall through the cracks or get substandard quality of mental health care. The goal of this quality improvement project was to develop and implement a screening algorithm for depression diagnosis, management, and referrals in primary care; it sought to improve the identification and treatment of patients with major depressive disorder while flagging those that could potentially have bipolar spectrum disorder for referrals for further assessment and treatment. Over a 6-week implementation period, 30 patients, constituting 5.3% of all screened patients were identified with depressive symptoms suggestive of mood disorder. Out of those, 24 were confirmed to have a major depressive disorder (MDD) and started on antidepressants at primary care level and 6 were flagged for assessment for bipolar disorder (BPAD). All 30 patients were referred to have intake appointments at the mental health department, constituting a 20% increase in referrals. Five out of 6 patients flagged for potential BPAD were confirmed with the diagnosis. This was a significant finding as only one patient was referred and diagnosed with bipolar disorder at the previous baseline. Patients started on antidepressants had marked improvements in their clinical picture as noticed by the decrease in mean PHQ9 from 19.4 at baseline to 13.03 at follow-up (P\u3c0.0001). There was also a significant increase in providers ordering baseline labs. The algorithm effectively improved the overall mental health care delivered at primary care levels by bettering provider knowledge about screening, diagnosing, and managing mood disorders. Future studies should aim for a more extensive implementation for higher sample size and assess long-term responses to interventions. Key words: Depression, major depressive disorder, screening algorithm, bipolar disorder
Review of Averting the Digital Dark Age: The Future of Digital Literary Heritage
Full text linkIn Averting the Digital Dark Age: How Archivists, Librarians, and Technologists Built the Web a Memory, Ian Milligan explores the efforts of technologists and information professionals to develop means of preserving information shared on the World Wide Web. The web lacks a built-in archiving function, raising fears of a “digital dark age,” an unprecedented gap in the historical record as information sharing via the web increases. Milligan tracks the development of web preservation debates and activities from the anxiety and turmoil of the early to mid-1990s to the coming of age of web preservation in the wake of the terrorist attacks of September 11, 2001. This concise and accessible book makes clear the fragility of web-based information and the importance of collaborative web preservation efforts
Community Defining Archives: A comparative view of community archives definitions
No full textDefining community archives has been described as difficult in academic literature because of the wide range of activities the organizations do and who they represent, leading to a lack of an agreed-upon definition in the field. Until now, a comparison between how community archivists describe themselves and academic definitions of community archiving has not been undertaken. This paper explores the definitions of community archives given by practitioners in their digital community archives and compares them with academic literature. Using both qualitative thematic coding and quantitative word frequency counts, this study found Flinn (2007) and Flinn et al. (2009) definitions are commonly used in academic literature and highlights themes in practitioner definitions, like futurity and access, that provide insight into the values and goals of practitioners. The results indicate areas of improvement for community archives academics who hope to accurately portray community archives work and further highlight the importance of working with and supporting community archivists. Without the inclusion of practitioner definitions, descriptions, and ideas, academic literature about community archives is disconnected from the field, barring the creation of new ideas and methods
Pipeline vs. Choice: The Global Gender Gap in STEM Applications
No full textWomen account for only 35% of global STEM graduates, a share unchanged for a decade. We use administrative microdata from centralized university admissions in ten systems to deliver the first crossnational decomposition of the STEM gender gap into a pipeline gap (academic preparedness) and a choice gap (first-choice field conditional on eligibility). In deferred-acceptance platforms where eligibility is score-based, we isolate preferences from access. The pipeline gap varies widely, from -19 to +31 percentage points across education systems. By contrast, the choice gap is remarkably stable: high-scoring women are 25 percentage points less likely than men to rank STEM first
From The Heaviest, Dirtiest Depths to the Washy Ambient Clouds: Guitar Timbre in/as Schismogenesis in North American Christianity
No full textThis essay argues that within the socio-cultural context of North American Christianity, the timbral qualities of electric guitar, with its long lineage as a site of cultural values conflict and identity negotiation, serves a theological function in the emerging and cohering sonority of digital worship. Using as comparative case studies the timbral qualities of delay and ambience as promoted and sold by Worship Tutorials as representing normative sonic values for these Christians, on the one hand, and the dialectic and schismatic deployment of distortion by the band My Epic on the other, we suggest that these timbral qualities become important sites of theological and ethical negotiation. Further, these sites of negotiation serve as the raw material for the construction of differentiating space for identity and belonging in musical communities, facilitating the emergence of new communities as well
Enhancing Archives and Records Management in Low-Resourced Organizations through Experiential Learning
No full textMaster’s students in Archives and Records Management could help low-resourced organizations address their Archives and Records Management needs while gaining practical experience. Archives and Records Management education programs could facilitate this mutually beneficial relationship by offering internships and service-learning courses. This paper analyzes the strengths and limitations of these two experiential learning mechanisms and discusses solutions to overcome the limitations. It argues that service-learning is especially suitable for addressing the Archives and Records Management needs of low-resourced organizations and proposes a service-learning model for that purpose
Digital Ecosystems and Data Regulation
Full text linkThis paper provides a framework in which a multiproduct ecosystem competes with many single-product firms in both price and innovation. The ecosystem is able to use data collected on one product to improve the quality of its other products. We study the impact of data regulation which either restricts the ecosystem\u27s cross-product data usage, or which requires it to share data with small firms. Each policy induces small firms to innovate more and set higher prices; it also dampens data spillovers within the ecosystem, reduces the ecosystem\u27s incentive to collect data and innovate, and potentially increases its prices. As a result, data regulation has an ambiguous impact on consumers, and is more likely to benefit consumers when small firms are relatively more efficient in innovation. A data cooperative among small firms, which helps them to share data with each other, does not necessarily benefit small firms and can even harm consumers