RESUMO
Landslides are frequent and damaging natural hazards that threaten the people and the natural and built environments of Puerto Rico. In 2017, more than 70,000 landslides were triggered across the island by heavy rainfall from Hurricane María, prompting requests by local professionals for landslide education and outreach materials. This article describes a novel collaborative risk communication framework that was developed to meet those requests and shaped the creation of a Spanish- and English-language Landslide Guide for Residents of Puerto Rico. Collaborative risk communication is defined here as an iterative process guided by a set of principles for the interdisciplinary coproduction of hazards information and communication products by local and external stakeholders. The process that supports this form of risk communication involves mapping out the risk communication stakeholders in the at-risk or -disaster-affected location-in this case Puerto Rico-and collaborating over time to address a shared challenge, such as landslide hazards. The approach described in this article involved the formation of a core team of government and university partners that expanded in membership to conduct collaborative work with an informal network of hazards professionals from diverse sectors in Puerto Rico. The following principles guided this process: cultural competence, ethical engagement, listening, inclusive decision -making, empathy, convergence research, nested mentoring, adaptability, and reciprocity. This article contributes to the field of risk communication and emergency management by detailing these principles and the associated process in order to motivate collaborative risk communication efforts in different geographic and cultural contexts. While the work described here focuses on addressing landslides, the principles and process are transferable to other natural, technological, and willful human-caused hazards. They may also serve as a roadmap for future partnerships among government agencies and university researchers to inform the cocreation of science education and outreach tools.
Assuntos
Tempestades Ciclônicas , Desastres , Deslizamentos de Terra , Comunicação , Humanos , Porto RicoRESUMO
BACKGROUND/OBJECTIVES: Maternal obesity increases risk for childhood obesity, but molecular mechanisms are not well understood. We hypothesized that primary umbilical vein endothelial cells (HUVEC) from infants of overweight and obese mothers would harbor transcriptional patterns reflecting offspring obesity risk. SUBJECTS/METHODS: In this observational cohort study, we recruited 13 lean (pre-pregnancy body mass index (BMI) <25.0 kg m-2) and 24 overweight-obese ('ov-ob', BMI⩾25.0 kg m-2) women. We isolated primary HUVEC, and analyzed both gene expression (Primeview, Affymetrix) and cord blood levels of hormones and adipokines. RESULTS: A total of 142 transcripts were differentially expressed in HUVEC from infants of overweight-obese mothers (false discovery rate, FDR<0.05). Pathway analysis revealed that genes involved in mitochondrial and lipid metabolism were negatively correlated with maternal BMI (FDR<0.05). To test whether these transcriptomic patterns were associated with distinct nutrient exposures in the setting of maternal obesity, we analyzed the cord blood lipidome and noted significant increases in the levels of total free fatty acids (lean: 95.5±37.1 µg ml-1, ov-ob: 124.1±46.0 µg ml-1, P=0.049), palmitate (lean: 34.5±12.7 µg ml-1, ov-ob: 46.3±18.4 µg ml-1, P=0.03) and stearate (lean: 20.8±8.2 µg ml-1, ov-ob: 29.7±17.2 µg ml-1, P=0.04), in infants of overweight-obese mothers. CONCLUSIONS: Prenatal exposure to maternal obesity alters HUVEC expression of genes involved in mitochondrial and lipid metabolism, potentially reflecting developmentally programmed differences in oxidative and lipid metabolism.
Assuntos
Células Endoteliais da Veia Umbilical Humana/metabolismo , Metabolismo dos Lipídeos/genética , Mães , Obesidade/genética , Complicações na Gravidez/genética , Cordão Umbilical/citologia , Adulto , Estudos de Coortes , Feminino , Desenvolvimento Fetal , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Humanos , Lactente , Inflamação/fisiopatologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Mitocôndrias/metabolismo , Obesidade/metabolismo , Obesidade/patologia , Obesidade/prevenção & controle , Gravidez , Complicações na Gravidez/metabolismo , Complicações na Gravidez/patologia , Efeitos Tardios da Exposição Pré-NatalRESUMO
The position of Singapore as regards birthweight distribution and perinatal mortality has been compared with six countries in the 1973 WHO study namely, Austria, Cuba, Hungary, Japan, New Zealand and Sweden. Birthweight distribution and perinatal mortality reflect both the social and health conditions of a population and the standards of obstetric and paediatric care, and seeing where a country ranks in the international comparison of them may play a role in the formulation of health policy for that country. Singapore was well placed for the proportion of very low birthweight babies (less than 1,500 grams), ranking 2nd for both live births (0.5%) and total births (0.7%). It was however not so well placed for proportion of low birthweight babies (less than 2,500 grams), ranking 5th for both live births (8.8%) and total births (9.2%). With regard to perinatal mortality Singapore at 20.0 per 1,000 total births ranked 4th and this improved to 3rd after standardizing for birthweight and in fact was little different from Hungary (1st) and Sweden (2nd). Given that standardization for birthweight largely removes the effect of "socioeconomic and demographic factors" so that remaining differences to a large extent reflect medical care, this indicates a relatively high standard of perinatal care in Singapore. The problems of interpretation, the implications of the findings and suggestions for improving birth statistics in Singapore are discussed.
PIP: The situation in Singapore with regard to birthweight disbribution and perinatal mortality has been compared with 6 other countries in the 1973 WHO study. Those countries are: Austria, Cuba, Hungary, Japan, New Zealand, and Sweden. Birthweight distribution and perinatal mortality reflect both the social and health conditions of a population and the standards of obstetric and pediatric care. By evaluating where a country ranks in an international comparison, it is then possible for that country to formulate an appropriate health policy. Singapore ranked well in the proportion of very low birthweight babies (less than 1500 grams), ranked 2nd for livebirths (0.5%) and total births (0.7%), but did not rank as well in proportion of low birthweight babies (less than 2500 grams). Furthermore, Singapore ranked 5th for both live births (8.8%) and total births (9.2%). In the category of perinatal mortality, Singapore, with a rate of 20.0/1000 total births, ranked 4th and then moved into 3rd place after standardizing for birthweight. There was in fact little difference between Singapore and the 1st ranked (Hungary) and 2nd place (Sweden) countries. Given that standardization for birthweight removes for the most part the socioeconomic and demographic factors and leaves those factors reflecting medical care, this indicates a relatively high standard of perinatal care in Singapore. This article also examines problems of interpretation, the implications of the findings, and suggestions for improving birth statistics in Singapore.