How Hydropeaking Can Decrease Population Sizes In River Ecosystems

Hydropeaking is fluctuation in the flow/water levels of a river or stream, in this case caused by the sudden release of water from hydroelectric dams and hydropower stations. The river volume is controlled day by day, or even hour by hour in order to meet electricity demands. These sudden disturbances to the rivers water levels can disrupt egg laying patterns of some insect and fish species living in the river as normally (without hydropeaking) the river’s water levels do not change so quickly. Because the water level can fall so suddenly, any eggs laid near the shore, just below the river’s surface (e.g. by caddis flies, mayflies and stoneflies) will dry out and any hatched larvae will be stranded and die.

This is a huge concern as some of these insect species are a vital food source for other wildlife within the river ecosystem. This means that by getting rid of a primary consumer, larger species of secondary consumers will have to compete for other food sources or won’t have any food source at all. This then leads to a decrease in population size of the consumers relying on the insects as a food source.

The sudden drop in water level can also cause sediment to cover fish eggs, so they then cannot hatch, further decreasing the fish population size.

Dams also have other adverse effects on river ecosystems such as altering the flow and temperature of the river and blocking migratory paths.

Around 800000 dams exist globally and hydropower provides 19% of the world’s electricity supply. Hydropower is a renewable resource, so means the more we use it, the less we have to rely on fossil fuel, therefore, until a better alternative is invented, we need hydropower. However, we could decrease the adverse effects of hydropeaking by leaving the rivers water levels stable for a few days at a time, instead of suddenly changing the water levels, so that the insects could lay their eggs and let them hatch with success. Of course this doesn’t completely solve the problem, but it is a step towards solving it.

Introduction to Ecosystems and Ecology

Ecology is the study of the inter-relationships between organisms and their environment (including abiotic (non-living) and biotic (living) factors) and it pretty much spans most of biology. It studies the biosphere, which is the land, water and air which supports life and surrounds the Earth. It includes all living organisms on earth, together with the dead organic matter produced by them. Ecology is essential to our understanding of life on Earth (well, in my opinion anyway 😉 )

Here is a helpful (I hope) flow chart of how everything (well, not everything, obviously…) fits together:

 

 

Microcephaly:

Microcephaly is a neurodevelopmental disorder where (in most cases) the baby’s head circumference is smaller than normal (more than 2 standard deviations below the mean for the baby’s age and sex) and is associated with incomplete brain development. This can be deadly if the brain is so underdeveloped that vital, life functions can’t be regulated. Children with microcephaly often have developmental issues, although some have normal intelligence and development. However there may be complications (depending on the cause and severity of the case), including hyperactivity, seizures, mental development problems, dwarfism, coordination and balance issues or developmental delay.

There’s an unconfirmed, but suspected link between Zika Virus and microcephaly, because as there’s been a rise in Zika cases in Brazil, there’s also been a rise of cases of microcephaly. Zika is mainly transmitted through the Aedes mosquito (which can also spread dengue and yellow fever). Zika virus isn’t usually considered very harmful apart from to pregnant women, or those thinking of becoming pregnant and only about 1 in 5 of those with the virus show symptoms. Symptoms include fever, rashes, headaches and conjunctivitis and they usually only last about a week.

During the Zika outbreak, women in Brazil have been advised to delay getting pregnant for the next few years and women thinking of getting pregnant have been advised against traveling in Zika affected areas, as there is no known cure for the virus. Some say we are at least 3 years away from finding one, and some scientists say we at least 10 years away from a vaccine.

Other causes of Microcephaly also include Craniosynostosis (The premature fusing of the joints between the bony plates that form the infant’s skull and keeps the brain from growing), Infections of the foetus during pregnancy. (e.g toxoplasmosis, cytomegalovirus, rubella and chicken pox), Down syndrome and other conditions caused by chromosomal abnormalities, exposure to drugs, alcohol or certain toxic chemicals in the womb, cerebral anoxia (decreased oxygen to the foetal brain due to complications during pregnancy and delivery), severe malnutrition and uncontrolled phenylketonuria (PKU), in the mother. (PKU is a birth defect that hampers the body’s ability to break down the amino acid phenylalanine).

Microcephaly is usually detected at birth or at baby check-ups. To determine whether a child has microcephaly or not, the baby’s head circumference will be measured and compared to a growth chart and growth will be tracked. Family history and parents’ head sizes may also be checked. In some cases a CT scan or MRI and blood tests may be used to help determine the cause of any development issues.

Neural Tube Defects- Encephalocele:

Like Spina Bifida, Encephalocele (also known as cranium bifidum) is the herniation of the brain tissue and meninges but is outside the skull, instead of the spine. The result is bulge of brain tissue, meninges or parts of bone, from the skull and is usually located down the midline occipital area of the skull (middle back), but it could really happen at any part of the head. It is a rare type of NTD and according to CDC, 1 in 10000 babies are born with it in the USA.  This occurs when the neural tube doesn’t close properly, leading to a herniation process which appears as a sac protruding through a defect in the cranial vault. This means the embryo’s cells which form the skull don’t come together to close over the brain. Encephaloceles toward the back of the skull are associated with neurological problems, whereas those towards the front of the skull don’t usually contain brain tissue, so therefore generally have less of an adverse effect.

We don’t know the cause of Encepaloceles, but it is believed that both genetic and environmental factors contribute towards it. For example it’s more common in those who a family history of NTD’s (e.g. Spina Bifida and Anencephaly).

As with other NTD’s, screening methods include AFP serum screening and ultrasound, although because encephalocele is skin covered, AFP is less effective.

Encephalocele can be sub-classified as cranial meningocele, encephalocystomeningocele and encephalomeningocele.

Neural Tube Defects- Spina Bifida:

 Spina Bifida is a Spinal Neural Tube Defect caused by the vertebral arch of the spinal column (from the base of the skull to the sacrum) being unformed or incompletely formed, but is most commonly found in the lumber region (where the vertebrae at the base of the neural tube haven’t closed). This could result in the exposure of the spinal cord or meninges (three layers of protective tissue called the dura mater, arachnoid mater, and pia mater that covers the brain and spinal cord). You can surgically close this exposure.

Spina Bifida can be classified as Spina Bifida Occulta or Spina Bifida Cystica.

Spina Bifida Occulta is the most common form of Spina Bifida and is the “closed” form of Spina Bifida, where the skin is intact and there is no exposure of the meninges or spinal cord. However at least one of the vertebrae is malformed/ not fully developed. Sometimes, this is also called Occult Spinal Dysaphism which is when the spinal nerves or meninges are mixed up with their surrounding structures, causing complications.  There are usually no neurological sequelae or long-term consequence with Spina Bifida Occulta but scoliosis/ other spinal deformities could develop along with lower back pain. Also, other problems such as bladder infections and incontinence, constipation or reduced feeling/numbness in the legs or feet could develop.

Spina Bifida Cystica is the “open” form, where there are visible signs of Spina Bifida (a cyst/sac on the back). There are 3 types of Spina Bifida Cystica:

  • Meningocele: This is the least common form of Spina Bifida and is when the cyst contains cerebrospinal fluid or meninges. There’s no spinal neural fluid in the sac. Development of the Spinal Cord may be affected. Meningocele does not necessarily cause neurological symptoms.

  • Myelomenigocele: This is the most common form of Spina Bifida Cystica and is where the cyst contains tissue and cerebrospinal fluid, nerves and part of the spinal cord. This means that the spinal cord will not develop properly or will be damaged, leading to some paralysis and the loss of feeling below the damage part of the cord.

  • Rachischisis: This is the most severe form of Spina Bifida Cystica and is often associate with anencephaly. It is where the spine lies widely open and the neural plate has spread out on to the surface.

AFP screening and Ultrasound are used to diagnose Spina Bifida. It is thought that AFP screening is 80% sensitive for Spina Bifida Cystica. The foetal head is examined in the Ultrasound scan, especially the shape of the skull/ appearance of the cerebellum.  Signs usually include the skull being lemon shaped and the flattening/loss of the median sulcus (banana shaped).

Neural Tube Defects- Anencephaly:

Anencephaly is a condition in which the top of the neural tube hasn’t closed completely (Cranial Neural Tube Defect), causing the baby to be born without parts of the brain or skull. This usually arises between the 23rd and 26th day of pregnancy. It is a lethal condition and sadly it means that the baby usually only lives for a few days, and in the case of Hope Lee, only 74 minutes. She was born last week and became the UK’s youngest organ donor. Her parents found out that she had anencephaly in the 13th week of pregnancy and knew that she wouldn’t have a long life span but they didn’t want to terminate the pregnancy. They agreed to Hope’s kidneys being made available for transplant.

Centers for Disease Control and Prevention (CDC) researchers found that lack of folic acid could be a cause of anencephaly, and Perinatal Institute say that there are “reported associations with maternal insulin dependent diabetes, hyperthermia and obesity”.

There are two screening methods used in the UK- Maternal Serum AFP (Alpha-Fetoprotein) and Ultrasound (usually offered at 18-20 weeks). 

AFP serum screening looks at the AFP levels in the mother’s blood and is usually done at 16-20 weeks of pregnancy. It is thought to be more than 90% sensitive for Anencephaly and is especially recommended for women with a family history of birth defects, are 35 or older, who used possibly harmful medications/drugs during pregnancy or who have diabetes. AFP is found both in foetal serum and amniotic fluid. It’s a protein which is produced during the early stages of pregnancy by the foetal yolk sac and in the liver and gastrointestinal tract. We don’t really know what AFP does though…but we do know that it’s levels increase and decrease and different weeks of pregnancy. High levels of AFP may suggest that the baby has a Neural Tube Defect or could also suggest defects with the oesophagus or a failure of the baby’s abdomen to close, but most commonly, the reason for higher AFP levels is due to inaccurate dating of the pregnancy. Low levels of AFP and abnormal levels of hCG (human chorionic gonadotropin (hormone)) and estriol could be an indication of the baby having a chromosome abnormality such as Down Syndrome or Edwards Syndrome.

At the moment there is no cure for Anencephaly, so treatment is symptomatic rather than curative.

Weekend Mortality Rates

Being honest, I actually started writing this last week…but I may have got slightly distracted so I’m writing it now…and sorry for not posting in ages!…so anyway…

I was looking at BBC News Health and the headline Weekend births ‘pose higher death risk’ stood out for me. According to a study based on 1.3 million births, there was a 7% higher chance of death at the weekend than in the week (7.1 deaths out of every 1000 deliveries at the weekend) and in total, there are averagely 4500 deaths per year from 67500 births. It was also found that infection rates for mothers and injuries to the babies (anything from cuts to brain damage) were higher at weekends.

Interestingly, the day with the lowest death rate is Tuesday and the day with the highest risk of death was actually Thursday (but then on average weekends held a higher risk than weekdays); if every day was a Tuesday then there would be 770 less deaths per year.

The higher weekend mortality rate isn’t just a problem in the maternity unit or in England. In July, an article in the Nursing Times was published about a study looking at the Global Comparators project (an international database to which over 50 hospitals from the UK, US, Australia, the Netherlands, Italy, Spain, Belgium, Finland, Norway and Denmark contribute); they found that, after taking account of other factors, the risk of dying within 30 days of emergency admission or elective surgery was higher for emergency admissions at weekends in three out of the four countries studied (28 teaching hospitals in England, Australia, the US and the Netherlands) and all patients admitted for planned weekend surgery had a higher chance of dying within 30 days than those admitted during the week. This risk was 8% higher in eleven hospitals in England, 13% higher in five of the US hospitals, and 20% higher in six Dutch hospitals.

These studies raise a number of concerns; why is the standard of care lower on a weekend? Why can’t every day be like a Tuesday?

And in turn, these concerns lead to questions- What can we do about it and what will this mean for midwives in the future?

Of course, I can’t predict the future but these studies back up the 7 day week plans to increase availability of weekend services, so I believe that midwives will end up working longer hours and have longer weeks. I just worry that working longer will lead to more mistakes.

But anyway, I know these things can’t really be controlled but try not to have a baby on a Thursday or at the weekend; you are much better off giving birth on a Tuesday.

Regional Divide In Smoking In Pregnancy

Ok, so I’ve been meaning to post for ages now! …There’s been so much to blog about, so I will catch you up on it, but I’m going to start with a headline from the BBC News website which caught my eye this morning: “Regional divide in smoking in pregnancy”.

According to NHS data, 27.2% of pregnant women in Blackpool smoke throughout pregnancy compared with 2.1% in Westminster. The total rate has fallen to under 11% in England, but the “Smoking in Pregnancy Challenge Group” report urges a national target of below 6% by 2020. Prof. Russel Viner, at the Royal College of Paediatrics and Child Health, also says that teenage mothers-to-be “are almost six times as likely to smoke throughout pregnancy as women who are over 35”. Obviously, smoking is bad for the mother, but it is also bad for the baby and causes many problems during pregnancy.

Cigarette smoke contains more than 4,000 chemicals, including cyanide, lead, and at least 60 carcinogens. These chemicals then pass into your bloodstream and some are able to pass through the placenta and are affectively “fed” to the baby (as the blood is it’s only source of nutrients). The two most harmful of the chemicals in cigarettes are nicotine and carbon monoxide. According to James Christmas (oo, cool name! 😉 ) (director of Maternal Foetal Medicine for Commonwealth Perinatal Associates at Henrico Doctors’ Hospital in Richmond, Virginia) (wow…long title…), Nicotine and CO “account for almost every smoking-related complication in pregnancy”. These include stillbirth, miscarriage, premature birth and low birth weight. This is because CO and nicotine reduce the blood supply to the baby (nicotine narrows the blood vessels and carbon monoxide binds to the haemoglobin reducing their ability to bind to oxygen, therefore reducing the oxygen supply to the baby). Smoking also affects the baby in later life; children of mothers who smoke whilst they are pregnant are more likely to have learning disorders, behavioral problems, lower IQs and developmental problems. Continuing or returning to smoking after birth also increases the risk of cot death and increases chance of asthma and respiratory infections. Second-hand smoke also increases the likelihood of complications during pregnancy.

According to BBC News, in the UK smoking during pregnancy causes:

  • 2200 premature births

  • 5000 miscarriages

  • 300 stillbirths

…each year! And also, every year, more than 70,000 pregnancies are affected by smoking.

So, basically…don’t smoke during pregnancy…despite the myth that having a small baby will make labour easier, it isn’t true- it doesn’t mean an easier birth and the baby may have to stay in hospital after they are born.

Ok…I’ll shall post soon to catch up on those sneaky news stories which keep creeping up on me! 😉 see ya!

ICMC

     So, next year I will be going on a gap year and I plan on spending 2 months in India at the Indian Christian Mission Centre Orphanage (shining faces in India)- one of the largest orphanages in India which looks after the physical, emotional, and spiritual well-being of orphans in southern India. I will be teaching English, playing with the younger children and helping with projects as well as getting to know the children andDSC_0506 bright just generally helping out and trying to make a difference.

I am attempting to raise at least £1000 as a donation to the orphanage; this could pay for new school equipment, playground equipment, beds… and it will all go towards the orphanage and the children. Throughout the next year I am pretty sure I will be taking part in events/fundraisers (e.g. horrible running stuff!) to help raise money for the charity. Please, if you are able, donate towards this amazing charity on my Virgin Money Giving DSC_7524 brightpage (this link here…), not for me, but for the children- just £10 is a 1% share in the massive difference this money will make to the lives of the children in one of the largest orphanages in India. Thank you for reading and I really hope that I can reach my goal for the children.

Hospital Work Experience #2 – Day 5

It came far too quickly, but today was my final day of hospital work experience L. I spent the morning in Orthodontics department. Orthodontics is the study and treatment of malocclusions (improper bites), which may be a result of tooth irregularities and/or disproportionate jaw relationships. People have orthodontic treatment for three main reasons: To improve the appearance of their teeth and face, to improve the health of their teeth and gums or to make it easier to eat.

So I saw braces being put on, removed and being adjusted (tightened, replaced brackets or bands…) and I also saw moulds being made of the mouth. Moulds are made and photos are taken at the beginning and end of treatment to get a proper view of the teeth and jaw position and to show the improvement after treatment. There are different types of braces but the most common type is the fixed brace (train tracks). These are made up of metal brackets which are glued to your teeth (and the glue is light sensitive, the orthodontist uses a strong light to set it) and a metal wire which links up the brackets. The wire comes in different thicknesses and usually they get progressively thicker as the treatment goes on.

I then went on to the Private wing of the hospital.

This ward was very different to the others I’d been on because instead of having a few bays with many beds in and a few private side rooms, there were just private rooms which had their own toilet and shower. The rooms all have a flat screen tv with Freeview and they have unlimited visiting (so there aren’t set visiting times). Patients can receive treatment almost immediately and on a date to suit them instead of waiting on a list for a slot. It was also a lot quieter and calmer than the other wards. I shadowed a HCA and helped with handing out drinks (which was great because I got to talk to the patients), with checking the Resuscitation Trolley (which contained the defibrillator and lots of other equipment. Every draw had to be checked to make sure it was all there and in date) and taking patient obs.

Well, this is the end of my week in the hospital L. Sorry I’ve been so brief but I’ve got to pack as I’m about to go on holiday!!!!! Stay positive and good luck everyone for results next week; I’m sure you’ve all done amazingly and you will study medicine!!!