To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Psychiatry in the UK has longstanding recruitment problems (1). Evidence suggests the positive effects of clinical attachments on attitudes towards psychiatry are often transient (2). We therefore created the Psychiatry Early Experience Programme (PEEP) where year 1 medical students are paired with psychiatry trainees and shadow them at work. Students will ideally remain in PEEP throughout medical school, providing consistent exposure to psychiatry and a broad experience of its subspecialties.
1. To present PEEP
2. To assess:
a. Students’ baseline attitudes to psychiatry
b. PEEPs’ impact on students’ attitudes to psychiatry
A prospective survey based cohort study of King’s College London medical students.
PEEP started in 2013. In this cohort all students that signed up were accepted.
Students’ attitudes towards psychiatry were assessed on recruitment using the ATP-30 questionnaire (3), and will be re-assessed annually.
127 students were recruited. Attitudes were positive overall. 73% listed psychiatry in their top three specialities. 95.3% agreed or strongly agreed that ‘psychiatric illness deserves at least as much attention as physical illness.’ 84.3% disagreed or strongly disagreed that ‘at times it is hard to think of psychiatrists as equal to other doctors.’
Baseline attitudes to psychiatry were positive. By March 2015 we aim to collect and analyse data on students’ attitudes after one year in PEEP. Through on-ongoing analysis of this and future cohorts, we aim to assess the impact of PEEP on improving attitudes to psychiatry and whether this will ultimately improve recruitment.
At Guy's King's and St Thomas’ School of Medicine, a unique initiative is the Psychiatry Early Experience Programme (PEEP), which allows students to shadow psychiatry trainees at work several times a year. The students’ attitudes towards psychiatry and the scheme are regularly assessed and initial results are already available.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Pressure ridges impact the mass, energy and momentum budgets of the sea-ice cover and present an obstacle to transportation through ice-infested waters. Quantifying ridge characteristics is important for understanding total sea-ice mass and for improving the representation of sea-ice dynamics in high-resolution models. Multi-sensor measurements collected during annual Operation IceBridge (OIB) airborne surveys of the Arctic provide new opportunities to assess the sea ice at the end of winter. We present a new methodology to derive ridge sail height from high-resolution OIB Digital Mapping System (DMS) visible imagery. We assess the efficacy of the methodology by mapping the full sail height distribution along 12 pressure ridges in the western and central Arctic. Comparisons against coincident Airborne Topographic Mapper (ATM) elevation anomalies are used to demonstrate the methodology and evaluate DMS-derived sail heights. Sail heights and elevation anomalies were correlated at 0.81 or above. On average mean and maximum sail height agreed with ATM elevation to within 0.11 and 0.49 m, respectively. Of the ridges mapped, mean sail height ranged from 0.99 to 2.16 m, while maximum sail height ranged from 2.1 to 4.8 m. DMS also delivered higher sampling along ridge crests than coincident ATM data.
The objectives of this work were (i) geographical analysis of the 2012–2014 outbreak of rabies in Greece using GIS and (ii) comparative analysis of animal cases with data of potential human exposure to rabies together with environmental data, in order to provide information for risk assessment, effective monitoring and control. Most animal cases (40/48) involved red foxes, while domestic animals were also diagnosed with rabies. Overall, 80% of the cases were diagnosed in central northern Greece; 75% of the cases were diagnosed in low altitudes (<343·5 m), within a distance of 1 km from human settlements. Median distance from livestock farms was 201·25 m. Most people potentially exposed to rabies (889/1060) presented with dog bite injuries. Maximum entropy analysis revealed that distance from farms contributed the highest percentage in defining environmental niche profiles for rabid foxes. Oral vaccination programmes were implemented in 24 administrative units of the country during 2013 and 2014, covering a total surface area of ~60 000 km2. Rabies re-occurrence in Greece emphasizes the need for ongoing surveillance in cross-border areas and in areas with intense human activity.
The bacterium Francisella tularensis causes the vector-borne zoonotic disease tularemia, and may infect a wide range of hosts including invertebrates, mammals and birds. Transmission to humans occurs through contact with infected animals or contaminated environments, or through arthropod vectors. Tularemia has a broad geographical distribution, and there is evidence which suggests local emergence or re-emergence of this disease in Europe. This review was developed to provide an update on the geographical distribution of F. tularensis in humans, wildlife, domestic animals and vector species, to identify potential public health hazards, and to characterize the epidemiology of tularemia in Europe. Information was collated on cases in humans, domestic animals and wildlife, and on reports of detection of the bacterium in arthropod vectors, from 38 European countries for the period 1992–2012. Multiple international databases on human and animal health were consulted, as well as published reports in the literature. Tularemia is a disease of complex epidemiology that is challenging to understand and therefore to control. Many aspects of this disease remain poorly understood. Better understanding is needed of the epidemiological role of animal hosts, potential vectors, mechanisms of maintenance in the different ecosystems, and routes of transmission of the disease.
The occurrence of Anaplasma phagocytophilum was investigated in spleen and serum samples from Swedish moose (Alces alces) in southern Sweden (island and mainland). Samples were analysed for presence of A. phagocytophilum DNA by real-time PCR (n = 263), and for Anaplasma antibodies with ELISA serology (n = 234). All serum samples had antibodies against A. phagocytophilum. The mean DNA-based prevalence was 26·3%, and significant (P < 0·01) temporal, and spatial variation was found. Island moose had significantly (P < 0·001) higher prevalence of A. phagocytophilum DNA than moose from the mainland areas. Two samples were sequenced to determine genetic variation in the 16S rRNA and groESL genes. Genetic sequence similarity with the human granulocytic anaplasmosis agent, equine granulocytic ehrlichiosis agent, and different wildlife-associated A. phagocytophilum variants were observed in the 16S rRNA and groESL genes. Our study shows that moose are exposed to A. phagocytophilum in Sweden, and represent a potential wildlife reservoir of the pathogen.
Tuberculosis (TB) in livestock, caused by Mycobacterium bovis, persists in many countries. In the UK and Ireland, efforts to control TB through culling of badgers (Meles meles), the principal wildlife host, have failed and there is significant interest in vaccination of badgers as an alternative or complementary strategy. Using a simulation model, we show that where TB is self-contained within the badger population and there are no external sources of infection, limited-duration vaccination at a high level of efficacy can reduce or even eradicate TB from the badger population. However, where sources of external infection persist, benefits in TB reduction in badgers can only be achieved by ongoing, annual vaccination. Vaccination is likely to be most effective as part of an integrated disease management strategy incorporating a number of different approaches across the entire host community.
The habitats of populations of small, pelagic fish, especially anchovy and sardine, in the Benguela, California, Humboldt, and Kuroshio-Oyashio current systems, and in the NE Atlantic, are described and discussed in regard to future climate change. These stocks have been the primary concern of the Small Pelagic Fish and Climate Change (SPACC) program of International GLOBEC. Each of these regions and stocks has a unique set of climate and ocean conditions and their variability. However, they also share common characteristics. Spawning and development occurs within broad ranges of temperature (12–26 °C) and salinity (<30–36) and in regions of high plankton production, associated with either upwelling or freshwater. Often, sardine are more oceanic and anchovy more coastal, often associated with wind-driven upwelling and rivers. Sardine tend to make longer migrations between spawning and feeding regions than do anchovy. The habitat of most populations of small, pelagic fish expands when the population size is large and contracts when it is small, often into refugia. Climate change may affect populations of small, pelagic fish by causing poleward shifts in distribution due to warming, some of which have already occurred. Other potential effects are due to changes in winds, hydrology, currents, stratification, acidification, and phenology.
Small, pelagic fish, especially anchovy and sardine, abound in many, productive regions of the world ocean. Their habitats include areas with coastal and oceanic upwelling and freshwater influence and can be characterized by both geography (properties of the coast and bottom) and hydrography (properties of the water). The effects of climate change, be it of natural or anthropogenic origin, on populations of small, pelagic fish, are mediated by their habitats.
In an outbreak of plasmid-free Salmonella enteritidis phage type 4 (PT4) food poisoning at a hospital for mentally handicapped people in July 1990, 101 residents and 8 staff were affected and a cohort study implicated beef rissoles cooked by deep-fat frying as the vehicle of infection (relative risk 2·92, 95% confidence interval 1·73–4·93, P ≪ 0·001). Replication of the cooking process demonstrated that the rissoles achieved core temperatures of only 48–60 °C despite external temperatures of 91–95 °C and an oil temperature of 142–154 °C. No residual food was available for microbiological testing but plasmid-containing S. enteritidis PT 4 was isolated in shell eggs from the hospital kitchen.
Livestock herbivores are at risk of inter- and intra-specific exposure to parasites/pathogens via the faecal–oral route during grazing. Each contact between livestock and faeces in the environment is a potential parasite/pathogen transmission event. Cattle grazing contact with faeces varies in relation to the species depositing the faeces and the distribution of the faeces. We used a foraging model to simulate the grazing behaviour of beef cattle in two grazing systems to compare the relative inter-specific and intra-specific exposure risks to parasites/pathogens. Overall, there is a greater level of intra- vs. inter-specific risk via the faecal–oral route. However, under certain conditions, particularly for microparasite infections, e.g. paratuberculosis in rabbits and bovine tuberculosis in badgers, wildlife may pose a significant exposure risk to parasites/pathogens. These risks can be enhanced when cattle are first turned out onto pasture and in situations where intra-specific variations in wildlife behaviour result in more dispersed defecation patterns.
Many of the most pervasive disease challenges to livestock are transmitted via oral contact with faeces (or by faecal–aerosol) and the current paper focuses on how disease risk may depend on: spatial heterogeneity, animal searching behaviour, different grazing systems and faecal deposition patterns including those representative of livestock and a range of wildlife. A spatially explicit agent-based model was developed to describe the impact of empirically observed foraging and avoidance behaviours on the risk of disease presented by investigative and grazing contact with both livestock and wildlife faeces. To highlight the role of spatial heterogeneity on disease risks an analogous deterministic model, which ignores spatial heterogeneity and searching behaviour, was compared with the spatially explicit agent-based model. The models were applied to assess disease risks in temperate grazing systems. The results suggest that spatial heterogeneity is crucial in defining the disease risks to which individuals are exposed even at relatively small scales. Interestingly, however, although sensitive to other aspects of behaviour such as faecal avoidance, it was observed that disease risk is insensitive to search distance for typical domestic livestock restricted to small field plots. In contrast disease risk is highly sensitive to distributions of faecal contamination, in that contacts with highly clumped distributions of wildlife contamination are rare in comparison to those with more dispersed contamination. Finally it is argued that the model is a suitable framework to study the relative inter- and intra-specific disease risks posed to livestock under different realistic management regimes.