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The worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings. Reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way. In 2015, the World Health Organization (WHO) commissioned a review of tools for data collection on the health of women and children in humanitarian emergencies. An update of this review was conducted to investigate whether the recommendations made were taken forward and to identify newly developed tools. Fifty-three studies and 5 new tools were identified. Only 1 study used 1 of the tools identified in our search. Little has been done in terms of the previous recommendations. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Currently used tools may not be suitable for use in humanitarian settings or may not include the domains of the authors’ interests. The development of standardized instruments should be done with all key workers in the area and could be coordinated by the WHO.
Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.
Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems.
The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.
Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39; mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome.
Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.
Listeriosis is a rare but severe foodborne illness which is more common in populations such as pregnant women, and can result in serious complications including miscarriage, prematurity, maternal and neonatal sepsis, and death in the newborn. Population recommendations exist for specific foods and food preparation practices to reduce listeriosis risk during pregnancy. The aim of the present systematic review was to assess the association between listeriosis and these practices during pregnancy to confirm appropriateness of these recommendations. We searched MEDLINE, Embase, CINAHL Plus, Web of Science Core Collection, included articles’ references, and contacted clinical experts. All databases were searched until July 2017. Case–control and cohort studies were included which assessed pregnant women or their newborn offspring with known listeriosis status and a nutritional exposure consistent with international population recommendations for minimising listeriosis. Outcomes included listeriosis with or without pregnancy outcomes. Risk of bias was assessed through the Newcastle–Ottawa Scale. Results were described narratively due to clinical heterogeneity in differences in nutritional exposures. Eleven articles comprising case–control or cross-sectional studies met the inclusion criteria. Cases of maternal, fetal or neonate listeriosis were more likely to have consumed high-risk dairy products, meat products or some fruits during pregnancy in comparison with women without listeriosis. Cases of listeriosis were more likely to have consumed foods that are highlighted in population guidelines to avoid to minimise listeriosis in comparison with those without listeriosis during pregnancy. Further research is warranted assessing means of improving the reach, uptake and generalisability of population guidelines for reducing listeriosis during pregnancy.
Little is known about Salmonella serovars circulating in backyard poultry and swine populations worldwide. Backyard production systems (BPS) that raise swine and/or poultry are distributed across Chile, but are more heavily concentrated in central Chile, where industrialized systems are in close contact with BPS. This study aims to detect and identify circulating Salmonella serovars in poultry and swine raised in BPS. Bacteriological Salmonella isolation was carried out for 1744 samples collected from 329 BPS in central Chile. Faecal samples were taken from swine, poultry, geese, ducks, turkeys and peacocks, as well as environmental faecal samples. Confirmation of Salmonella spp. was performed using invA-polymerase chain reaction (PCR). Identification of serovars was carried out using a molecular serotyping approach, where serogroups were confirmed by a multiplex PCR of Salmonella serogroup genes for five Salmonella O antigens (i.e., D, B, C1, C2-C3, and E1), along with two PCR amplifications, followed by sequencing of fliC and fljB genes. A total of 25 samples (1·4% of total samples) from 15 BPS (4·6 % of total sampled BPS) were found positive for Salmonella. Positive samples were found in poultry (chickens and ducks), swine and environmental sources. Molecular prediction of serovars on Salmonella isolated showed 52·0% of S. Typhimurium, 16·0% of S. Infantis, 16·0% S. Enteritidis, 8·0% S. Hadar, 4·0% S. Tennessee and 4·0% S. Kentucky. Poor biosecurity measures were found on sampled BPS, where a high percentage of mixed confinement systems (72·8%); and almost half of the sampled BPS with improper management of infected mortalities (e.g. selling the carcasses of infected animals for consumption). Number of birds other than chickens (P = 0·014; OR = 1·04; IC (95%) = 1·01–1·07), mixed productive objective (P = 0·030; OR = 5·35; IC (95%) = 1·24–27·59) and mixed animal replacement origin (P = 0017; OR = 5·19; IC (95%) = 1·35–20·47) were detected as risk factors for BPS positivity to Salmonella spp. This is the first evidence of serovars of Salmonella spp. circulating in BPS from central Chile. Detected serovars have been linked to human and animal clinical outbreaks worldwide and in Chile, highlighting the importance of BPS on the control and dissemination of Salmonella serovars potentially hazardous to public health.
We present the first VLBI measurement of interstellar ammonia (NH3) masers. Two masers were found toward the ultracompact Hii regions, W51-e1 and e2. The masers are unresolved in angle and smaller than 0.1 milliarcseconds. Unless these masers are highly beamed, they appear to be saturated.
The distance to a star forming region can be determined by measuring the proper motions within H2O maser clusters. If the motions of the maser spots are random, the distance can be determined by applying the technique known as statistical parallax. Alternatively, if organized motions are evident in the proper motions, one can model the source to estimate its the distance. Both methods rely on a comparison of the radial component of the motion (in km/s) and the proper motion on the plane of the sky (in milli-arcseconds/year).
The spatial distribution and polarization characteristics of the SiO (v=1, J=1-0) maser emission from several late type stars have been observed. The spatial distribution, derived from VLBI observations, generally shows a number of emitting regions but no clear velocity pattern or geometry. Some of these regions have well defined polarization characteristics. The results of high spatial resolution polarization measurements of RCas are similar to the lower spatial resolution polarimetry performed on this source.
Information on the structure of the molecular flow within 1″ of IRC-2, in Orion-KL, is sparse. Measurements of the continuum at 7.8μ and 12.5μ show a disk of size and suggest that the center of the disk may be dust free (Lester et al. 1985). Aperture synthesis mapping of water maser shell features (Sylber 1986) has provided information on the scale. Smaller scales can be studied by mapping SiO maser emission. We observed the 43 GHz, v=1, J = 1 → 0, transition of SiO using a 2 station interferometer with a 74 km baseline between Haystack Observatory, Westford, MA and Five College Radio Observatory, New Salem, MA. The fringe spacing was 20 milliarcseconds (mas) and the velocity resolution was 0.25 km-s−1. Our results provide the highest resolution view to date of what is likely to be the inner of IRC-2.
We limit the spectral index of density fluctuations in the interstellar plasma by comparing maser sizes, due to small-scale fluctuations, with wander of masers from constant velocity, possibly due to refraction by large-scale fluctuations. The wander of the masers about constantvelocity motion limits power-law spectra of the fluctuations to indices less than 4.0.
We observed several swarms of repeating low-frequency (1–5 Hz) seismic events during a 3 week period in May–June 2010, near the summit of Mount Rainier, Washington, USA, that likely were a result of stick–slip motion at the base of alpine glaciers. The dominant set of repeating events (‘multiplets’) featured >4000 individual events and did not exhibit daytime variations in recurrence interval or amplitude. Volcanoes and glaciers around the world are known to produce seismic signals with great variability in both frequency content and size. The low-frequency character and periodic recurrence of the Mount Rainier multiplets mimic long-period seismicity often seen at volcanoes, particularly during periods of unrest. However, their near-surface location, lack of common spectral peaks across the recording network, rapid attenuation of amplitudes with distance, and temporal correlation with weather systems all indicate that ice-related source mechanisms are the most likely explanation. We interpret the low-frequency character of these multiplets to be the result of trapping of seismic energy under glacial ice as it propagates through the highly heterogeneous and attenuating volcanic material. The Mount Rainier multiplet sequences underscore the difficulties in differentiating low-frequency signals due to glacial processes from those caused by volcanic processes on glacier-clad volcanoes.
The objective of this study was to evaluate the effect of the dietary inclusion of 6 g/kg dry matter intake of an unextracted Aurantiochytrium limacinum algae (AURA) in mid-lactation Italian Friesian cows under commercial conditions on milk yield, milk composition and docosahexaenoic acid (DHA) content. Cows were allocated to two groups (n = 18; 108.2 ± 66.1 and 104.4 ± 54.6 days in milk, control and treated groups, respectively). Feeding AURA for 84 d had no effect on dry matter intake, body condition score or weight gain, but did improve milk yield by 1.9 kg/cow/d (+5.4%; P < 0.1) over the course of the experiment. Milk fat concentration declined by 12% (P < 0.0001) without any significant change in 4% fat corrected milk, protein or lactose. Supplementing AURA for 12 weeks substantially altered the fatty acid profile of milk compared with milk from CON-fed cows such that the proportion of unsaturated fatty acids increased, omega-3 fatty acid content increased by 73.1% (P < 0.0001) and was accompanied by a favourable increase in the omega-3:6 fatty acid ratio by 75.0% (P < 0.0001). The AURA supplement, during day 7–84, increased the DHA concentration to 0.37 g /100 g milk total fatty acids (P < 0.0001) with a mean transfer efficiency of 18.1% from feed to milk. Together these results indicated that supplementing a dairy cow diet with DHA-rich microalgae is a feasible and efficient means for creating DHA-enriched milk for human consumption.
The UK has one of the largest systems of immigration detention in Europe.. Those detained include asylum-seekers and foreign national prisoners, groups with a higher prevalence of mental health vulnerabilities compared with the general population. In light of little published research on the mental health status of detainees in immigration removal centres (IRCs), the primary aim of this study was to explore whether it was feasible to conduct psychiatric research in such a setting. A secondary aim was to compare the mental health of those seeking asylum with the rest of the detainees.
Cross-sectional study with simple random sampling followed by opportunistic sampling. Exclusion criteria included inadequate knowledge of English and European Union nationality. Six validated tools were used to screen for mental health disorders including developmental disorders like Personality Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD) and Intellectual Disability, as well as for needs assessment. These were the MINI v6, SAPAS, AQ-10, ASRS, LDSQ and CANFOR. Demographic data were obtained using a participant demographic sheet. Researchers were trained in the use of the screening battery and inter-rater reliability assessed by joint ratings.
A total of 101 subjects were interviewed. Overall response rate was 39%. The most prevalent screened mental disorder was depression (52.5%), followed by personality disorder (34.7%) and post-traumatic stress disorder (20.8%). 21.8% were at moderate to high suicidal risk. 14.9 and 13.9% screened positive for ASD and ADHD, respectively. The greatest unmet needs were in the areas of intimate relationships (76.2%), psychological distress (72.3%) and sexual expression (71.3%). Overall presence of mental disorder was comparable with levels found in prisons. The numbers in each group were too small to carry out any further analysis.
It is feasible to undertake a psychiatric morbidity survey in an IRC. Limitations of the study include potential selection bias, use of screening tools, use of single-site study, high refusal rates, the lack of interpreters and lack of women and children in study sample. Future studies should involve the in-reach team to recruit participants and should be run by a steering group consisting of clinicians from the IRC as well as academics.
A distance of R0 = 7.6 ± 1.6 kpc for the galactic center is given by comparison of expansion parallax of a cluster of H2O masers in W49(N) with the kinematic distance of that source. Data from additional epochs, now being calibrated, should further improve the accuracy of our determination of R0.
Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.
Close binary systems may undergo the “Common Envelope” (CE) phase when the primary star expands on the red giant branch or the asymptotic giant branch. Filling its Roche Lobe, the primary transfers mass to the companion driving it out of thermal equilibrium and causing it to expand as well. The giant core and the companion star become surrounded by a CE. When sufficient energy is deposited in the circumstellar material this will be ejected and the binary orbit will shrink further (see review by Iben 1995). Planetary nebulae (PNe) with short-period binary nuclei are considered the most probable post-CE candidates. Abell 35, Lotr 1 and Lotr 5 (the Abell 35-like objects) are the only three PNe with binary nuclei known to contain a very hot UV-bright primary and a chromospherically active, rapidly rotating, G-K companion that dominates the optical spectrum. The origin of these unusual systems is unclear and hence presents a challenge to theories of binary star evolution. Identified in 1966 by Abell, Abell 35 is possibly the largest PN known (D=1.6 pc at a distance of 360 pc, Jacoby 1981) and also the oldest (the kinematical age is 185.000 years from the small expansion velocity of 4.2 km/s, Bohuski 1974). The bright giant star BD −22° 3467 (mv = 9.6mag) lies off-center within the nebula. A white dwarf was detected at the same location in 1988 in IUE spectra obtained by Grewing and Bianchi. BD − 22° 3467 has a vsin i of 90 km/s (Vilhu et al. 1991), variable Hα and Ca II emission lines associated with chromospheric activity, and a variable light curve (P=0.76 days, Jasniewicz and Acker 1988) probably produced by the rotation of the giant star. All attempts to determine the orbital period have failed, raising doubts as to whether the nucleus of Abell 35 is a close binary at all. In pursuit of this point, we have started a radial velocity study of the giant companion.
VLBI images of the H2O megamaser in NGC 4258 and a time series of spectra taken over several years combine to make a compelling case that there is a compact molecular disk associated with a supermassive object in the nucleus of this galaxy. The images of the maser in the velocity rangenear the systemic velocity show a highly elongated structure with a major axis of about 0.009 pc, along which the gradient in line-of-sight velocity is essentially a constant of 7970 ± 40 km s-1 pc-1. The observed acceleration of these spectral features by about 6-11 km s-1 yr-1, the presence of high-velocity maser satellite emission, and the VLBI results suggest emission from a disk of diameter0.2 pc, rotating with a velocity of ~800 Km s-1, bound by a mass of 1.5×107 M⊙ and denisty of ≳3.6×109 M⊙ pc-3
Objectives: Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI. Methods: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance. Results: Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning. Discussion: The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016, 22, 1–8)
The following trial was conducted to evaluate the impact of feeding Yea-Sacc® (YS; Alltech Inc, USA), a zootechnical feed additive based on a live probiotic strain of Saccharomyces cerevisiae, to lactating dairy cows over a 12 week period. Sixty-four primiparous and multiparous Holstein dairy cows, grouped to give similar range of parity, physiological and milk production stages, were selected for the study. Cows were equally allocated to either a control feed group or a diet supplemented with YS (32 cows per treatment). The test diet was formulated to include YS (Yea-Sacc® Farm Pak) incorporated in the total mixed ration (TMR), supplying a target dose of 5 × 107 CFU/kg feed dry matter (DM). This target dose delivered 1 × 109 CFU/cow/day, for a cow consuming 20 kg feed (DM basis) daily. Each cow was considered a replicate unit. Cows were fed a nutritionally adequate total TMR plus hay and a supplementary protein/energy concentrate (calculated according to milk yield) for 12 weeks, supplied once a day after the morning milking. Weigh backs of feed were recorded daily, with refusals being maintained at 3% of the total intake. During the 12 week study period, YS had significant beneficial effects on milk production (+0.8 kg/day; P = 0.003), energy corrected milk production (+1.4 kg/day; P < 0.0001), synthesis of milk protein (+36 g/day; P = 0.001), milk protein content (+0.3 g/kg; P = 0.009), and milk urea content (−0.09 mg/l; P = 0.004). The synthesis of milk fat was similar between treatments but milk fat content was lower for the YS group compared to the control group (−1.1 g/kg; P = 0.0002). Lactose content was always higher (+0.8 g/kg; P < 0.0001) for the YS group, indicating enhanced energy utilisation. In general, the effect of YS was higher during the first study period (one to seven weeks), when cows were in early lactation and the production potential was higher. YS cows produced significantly more milk during the study, and an additional 220 kg milk per cow was sold from this group from the output measured from the beginning of the study to two weeks post-trial. However, the statistical analysis including the post-study period did not show a significant effect. The 305-day simulated milk production was higher for the YS group (+400 kg/cow) but again the difference was not significant. In conclusion, YS at a target dose of 5 × 107 CFU/kg DM improved milk production and milk quality in healthy dairy cows. In addition, when the data were included in a whole-farm model, feeding YS reduced methane emissions by 4%, reduced the number of animals required for the desired milk production by 4% and increased overall farm margins by 1.4%.
Radio interferometric observations of extragalactic radio sources have been made with antennas at the Haystack Observatory in Massachusetts and the Owens Valley Radio Observatory in California during fourteen separate experiments distributed between September 1976 and May 1978. The components of the baseline vector and the coordinates of the sources were estimated from the data from each experiment separately. The root-weighted-mean-square scatter about the weighted mean (“repeatability”) of the estimates of the length of the 3900 km baseline was approximately 7 cm, and of the source coordinates, approximately or less, except for the declinations of low-declination sources. With the source coordinates all held fixed at the best available, a posteriori, values, and the analyses repeated for each experiment, the repeatability obtained for the estimate of baseline length was 4 cm. From analyses of the data from several experiments simultaneously, estimates were obtained of changes in the x component of pole position and in the Earth's rotation (UT1). Comparison with the corresponding results obtained by the Bureau International de l'Heure (BIH) discloses systematic differences. In particular, the trends in the radio interferometric determinations of the changes in pole position agree more closely with those from the International Polar Motion Service (IPMS) and from the Doppler observations of satellites than with those from the BIH.