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The completion of a laser safety course remains a core surgical curriculum requirement for otolaryngologists training in the UK. This project aimed to develop a comprehensive laser safety course utilising both technical and non-technical skills simulation.
Otolaryngology trainees and consultants from the West of Scotland Deanery attended a 1-day course comprising lectures, two high-fidelity simulation scenarios and a technical simulation of safe laser use in practice.
The course, and in particular the use of simulation training, received excellent feedback from otolaryngology trainees and consultants who participated. Both simulation scenarios were validated for future use in laser simulation.
The course has been recognised as a laser safety course sufficient for the otolaryngology Certificate of Completion of Training. To the authors’ knowledge, this article represents the first description of using in situ non-technical skills simulation training for teaching laser use in otolaryngology.
The illegal wildlife trade is driving declines in populations of a number of large, charismatic animal species but also many lesser known and restricted-range species, some of which are now facing extinction as a result. The ploughshare tortoise Astrochelys yniphora, endemic to the Baly Bay National Park of north-western Madagascar, is affected by poaching for the international illegal pet trade. To quantify this, we estimated population trends during 2006–2015, using distance sampling surveys along line transects, and recorded national and international confiscations of trafficked tortoises for 2002–2016. The results suggest the ploughshare tortoise population declined > 50% during this period, to c. 500 adults and subadults in 2014–2015. Prior to 2006 very few tortoises were seized either in Madagascar or internationally but confiscations increased sharply from 2010. Since 2015 poaching has intensified, with field reports suggesting that two of the four subpopulations are extinct, leaving an unknown but almost certainly perilously low number of adult tortoises in the wild. This study has produced the first reliable population estimate of the ploughshare tortoise and shows that the species has declined rapidly because of poaching for the international pet trade. There is an urgent need for increased action both in Madagascar and along international trade routes if the extinction of the ploughshare tortoise in the wild is to be prevented.
There is a well-established gender divide among people who do and do not seek professional help from mental health professionals. Females are typically more likely to report, and seek help for, mental health problems. The current paper sought to examine the role of employment context on help-seeking for mental health issues. We hypothesised that men and women in male-dominated occupations would be less likely to seek help than those in non-male-dominated occupations.
Data from the Household, Income and Labour Dynamics in Australia survey were used. Help-seeking, measured in 2013, was defined as whether a person reported attending a mental health professional in the 12 months prior to the survey. The exposure, male- and non-male-dominated occupations (measured in 2012), was defined using census data based on self-reported occupation. Analyses were stratified by gender and controlled for relevant confounders (measured in 2012), including mental health and prior help-seeking. We conducted multivariate logistic and propensity score analyses to improve exchangeability of those exposed and unexposed.
For males, being in a male-dominated occupation was independently associated with reduced likelihood of help-seeking (OR 0.66, 95% CI 0.46–0.95) in the adjusted model, although this result fell just out of significance in the propensity score analysis. There was no independent effect of being in a male-/non-male-dominated occupation for help-seeking among women.
Results suggest that male-dominated occupations may negatively influence help-seeking among males. There is a need for more research to understand this relationship and for workplace-based prevention initiatives.
Information on the distribution and abundance of the forest elephant Loxodonta cyclotis is needed to allocate limited resources appropriately and set conservation goals for the species. However, monitoring at large scales in forest habitats is complicated, expensive and time consuming. We investigated the potential of applying interview-based occupancy analysis as a tool for the rapid assessment of the distribution and relative abundance of forest elephants in eastern Cameroon. Using single-season occupancy models, we explored the covariates that affect forest elephant occupancy and detectability, and identified spatial and temporal patterns in population change and occupancy. Quantitative and qualitative socio-demographic data offer additional depth and understanding, placing the occupancy analysis in context and providing valuable information to guide conservation action. Detectability of forest elephants has decreased since 2008, which is consistent with the decline in perceived abundance in occupied sites. Forest elephants occupy areas outside protected areas and outside the known elephant range defined by IUCN. Critical conservation attention is required to assess forest elephant populations and the threats they face in these poorly understood areas. Interview-based occupancy analysis is a reliable and suitable method for a rapid assessment of forest elephant occupancy on a large scale, as a complement to, or the first stage in, a monitoring process.
The Critically Endangered saiga antelope Saiga tatarica faces an uncertain future, with populations dwindling from epidemics in its range countries, and ongoing demand for its horns in the traditional Chinese medicine trade. Singapore is a major hub for the global trade in saiga horn and an important consumer country, with saiga horn products widely available in the domestic market. Despite this, little is known about the consumers that drive domestic demand. Before interventions are carried out, it is important to understand who the consumers are, and their motivations. We conducted an investigation into consumption prevalence and consumer demographics, knowledge and motivations. We surveyed 230 Chinese Singaporeans, through a combination of face-to-face interviews and self-administered questionnaires. Recent consumption incidence (in the previous 12 months) was relatively high, at 13%. Younger respondents (18–35 years) had the highest prevalence of recent consumption (25%), often as a result of influence from an older family member or friend. Bottled saiga horn cooling water was the most popular product among recent users (50%), followed by horn shavings (31%) and tablets (13%). Awareness of conservation issues and regulations was uniformly low. Awareness raising may have an effect in reducing consumer demand in Singapore. However, given the exploratory nature of this study, it is best used to guide and inform future research underlying behavioural change interventions in a relatively understudied but important consumer group, Chinese Singaporeans.
Long-chain PUFA (LCPUFA) found in breast milk are derived from dietary sources and critical for optimal infant development. We examined associations between fish consumption and concentrations of LCPUFA and essential n-3 and n-6 fatty acids in breast milk among mothers living around Lake Victoria.
We used cross-sectional analyses of associations between recent fish consumption and breast-milk fatty acid concentrations.
The study was conducted around Lake Victoria on Mfangano Island, Kenya, where multiple fish species are key dietary components and also are widely exported.
In the previous 3 d, 97 % of women consumed a mean of 178 (sd 111) g fish (~2 servings/3 d). Mean breast-milk concentrations included DHA (0·75 % of total fatty acids), EPA (0·16 %), α-linolenic acid (ALA; 0·54 %), arachidonic acid (AA; 0·44 %) and linoleic acid (LA; 12·7 %). Breast-milk DHA concentrations exceeded the global average of 0·32 % in fifty-nine of sixty samples. We found native cichlids (Cichlidae) and dagaa (Rastrineobola argentea) contributed high levels of DHA, EPA and AA to local diets. We also found evidence for associations between fish species consumed and breast-milk LCPUFA concentrations when controlling for intake of other fish species, maternal body mass, maternal age, child age and exclusive breast-feeding.
The fatty acid composition of breast milk was influenced by the fish species consumed. Ensuring access to diverse fish and particularly inexpensive, locally available species, may be important for diet quality as well as infant growth and development.
To investigate the practice of hunting by local people in the southern Bahia region of Brazil and provide information to support the implementation of the National Action Plan for Conservation of the Central Atlantic Forest Mammals, we conducted 351 interviews with residents of three protected areas and a buffer zone. Thirty-seven percent of respondents stated that they had captured an animal opportunistically, 16% hunted actively and 47% did not hunt. The major motivation for hunting was consumption but people also hunted for medicinal purposes, recreation and retaliation. The most hunted and consumed species were the paca Cuniculus paca, the nine-banded armadillo Dasypus novemcinctus and the collared peccary Pecari tajacu; threatened species were rarely hunted. Opinions varied on whether wildlife was declining or increasing; declines were generally attributed to hunting. Our findings suggest there is illegal hunting for consumption in and around protected areas of the region. Management efforts should prioritize fairness in the expropriation process for people who must be relocated, and adopt an approach to wildlife management that involves residents living around the protected areas, and considers their needs.
Natural resources in and around protected areas in many countries in Africa are under intense pressure as a result of illegal behaviour, such as fishing, hunting and logging. A better understanding of local people's perceptions of the nature of illegal behaviour and the relevance of conservation actions would be useful in informing conservation decisions. We gathered information on the attitudes and perceptions of communities in the vicinity of Ugalla Game Reserve in western Tanzania regarding illegal behaviour and the effectiveness of conservation practices, using household surveys, key informants, and focus groups. We found that local people use the Reserve illegally, especially for hunting (28 ± SE 6%) and logging (20 ± SE 5%). We explored behaviours that are problematic for conservation in the partially protected areas around Ugalla. Local communities reported feeling isolated, harassed and intimidated by approaches used to protect Ugalla. They were angered by the conservation of Ugalla as a trophy hunting site for foreigners, and the excessive force and beatings used by game rangers to keep them away from the Reserve. Improving local livelihoods (17%), participatory conservation (16%), and giving people land for agricultural activities (16%) were among the ways that local communities felt would reduce illegal activities. Our findings suggest the need for conservation measures to benefit local communities around Ugalla transparently and equitably. Outreach programmes would help to raise conservation awareness and attract positive attitudes towards conservation. To encourage local support for conservation, we also suggest that conservation authorities create and maintain good relations with people living near the Reserve.
Making decisions about the management and conservation of nature is necessarily complex, with many competing pressures on natural systems, opportunities and benefits for different groups of people and a varying, uncertain social and ecological environment. An approach which is narrowly focused on either human development or environmental protection cannot deliver sustainable solutions. This volume provides frameworks for improving the integration of natural resource management with conservation and supporting stronger collaboration between researchers and practitioners in developed and developing countries. Novel approaches are required when ecological and social dynamics are highly interdependent. A structured, participatory, model-based approach to decision-making for biodiversity conservation has been proven to produce real-world change. There are surprisingly few successful case studies, however; some of the best are presented here, from fisheries, pest management and conservation. Researchers and practitioners need this interdisciplinary approach, focused on quantitative tools that have been tested and applied, and learning from success.
Prediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as ‘high risk’ to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV).
To identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours.
A systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours.
For all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9–7.9%), self-harm 26.3% (95% CI 21.8–31.3%) and self-harm plus suicide 35.9% (95% CI 25.8–47.4%). Subanalyses on self-harm found pooled PPVs of 16.1% (95% CI 11.3–22.3%) for high-quality studies, 32.5% (95% CI 26.1–39.6%) for hospital-treated self-harm and 26.8% (95% CI 19.5–35.6%) for psychiatric in-patients.
No ‘high-risk’ classification was clinically useful. Prevalence imposes a ceiling on PPV. Treatment should reduce exposure to modifiable risk factors and offer effective interventions for selected subpopulations and unselected clinical populations.