Developing Intensity-Duration-Frequency (IDF) Curves From Satellite-Based Precipitation: Methodology and Evaluation

Given the continuous advancement in the retrieval of precipitation from satellites, it is important to develop methods that incorporate satellite-based precipitation data sets in the design and planning of infrastructure. This is because in many regions around the world, in situ rainfall observations are sparse and have insufficient record length. A handful of studies examined the use of satellite-based precipitation to develop intensity-duration-frequency (IDF) curves; however, they have mostly focused on small spatial domains and relied on combining satellite-based with ground-based precipitation data sets. In this study, we explore this issue by providing a methodological framework with the potential to be applied in ungauged regions. This framework is based on accounting for the characteristics of satellite-based precipitation products, namely, adjustment of bias and transformation of areal to point rainfall. The latter method is based on previous studies on the reverse transformation (point to areal) commonly used to obtain catchment-scale IDF curves. The paper proceeds by applying this framework to develop IDF curves over the contiguous United States (CONUS); the data set used is Precipitation Estimation from Remotely Sensed Information Using Artificial Neural Networks – Climate Data Record (PERSIANN-CDR). IDFs are then evaluated against National Oceanic and Atmospheric Administration (NOAA) Atlas 14 to provide a quantitative estimate of their accuracy. Results show that median errors are in the range of (17–22%), (6–12%), and (3–8%) for one-day, two-day and three-day IDFs, respectively, and return periods in the range (2–100) years. Furthermore, a considerable percentage of satellite-based IDFs lie within the confidence interval of NOAA Atlas 14

Development and Evaluation of SENSE-ational Mealtimes: a Book for Families with Mealtime Difficulties

Many families with young children experience mealtime difficulties whereby the child eats a limited range of foods and/or refuses new food. Clinical interventions typically include behaviour training, enhancement of parenting skills and nutrition education. Clinical experience and a review of the literature across several domains suggested that interventions that optimise reflective functioning and understandings about sensory preferences at mealtimes are needed for both mild and complex mealtime difficulties. This study describes the development of the SENSE-ational Mealtimes book for families with mealtime difficulties and reports the findings of the initial evaluation. A questionnaire was used to assess the change in the frequency of difficult mealtimes, level of concern, understandings, feelings and goals of mothers 2 months after the book was distributed in a community setting. Mothers also provided feedback regarding helpfulness of the book, needs of families and recommendations. There was a statistically significant improvement in all aspects, namely frequency of mealtime difficulties, level of concern, understandings, feelings and goals. The subjective data indicated that the concepts instrumental in enhancing most mothers' understandings were how sensory preferences and past experiences of all members of the family had an impact on mealtime interactions. Initial evaluation suggests that wide-spread access to the SENSE-ational Mealtimes book could be an inexpensive approach to reduce the costs of adverse effects of mealtime difficulties on the emotional well-being of families and dietary intake of children. Mothers unanimously recommended the SENSE-ational Mealtimes book for both targeted prevention of and early intervention with mealtime difficulties in families

Sequelae due to bacterial meningitis among African children: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>African children have some of the highest rates of bacterial meningitis in the world. Bacterial meningitis in Africa is associated with high case fatality and frequent neuropsychological sequelae. The objective of this study is to present a comprehensive review of data on bacterial meningitis sequelae in children from the African continent.</p> <p>Methods</p> <p>We conducted a systematic literature search to identify studies from Africa focusing on children aged between 1 month to 15 years with laboratory-confirmed bacterial meningitis. We extracted data on neuropsychological sequelae (hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delay/impairment, and seizures) and mortality, by pathogen.</p> <p>Results</p> <p>A total of 37 articles were included in the final analysis representing 21 African countries and 6,029 children with confirmed meningitis. In these studies, nearly one fifth of bacterial meningitis survivors experienced in-hospital sequelae (median = 18%, interquartile range (IQR) = 13% to 27%). About a quarter of children surviving pneumococcal meningitis and <it>Haemophilus influenzae </it>type b (Hib) meningitis had neuropsychological sequelae by the time of hospital discharge, a risk higher than in meningococcal meningitis cases (median = 7%). The highest in-hospital case fatality ratios observed were for pneumococcal meningitis (median = 35%) and Hib meningitis (median = 25%) compared to meningococcal meningitis (median = 4%). The 10 post-discharge studies of children surviving bacterial meningitis were of varying quality. In these studies, 10% of children followed-up post discharge died (range = 0% to 18%) and a quarter of survivors had neuropsychological sequelae (range = 3% to 47%) during an average follow-up period of 3 to 60 months.</p> <p>Conclusion</p> <p>Bacterial meningitis in Africa is associated with high mortality and risk of neuropsychological sequelae. Pneumococcal and Hib meningitis kill approximately one third of affected children and cause clinically evident sequelae in a quarter of survivors prior to hospital discharge. The three leading causes of bacterial meningitis are vaccine preventable, and routine use of conjugate vaccines could provide substantial health and economic benefits through the prevention of childhood meningitis cases, deaths and disability.</p

Recommendations for Enhancing Psychosocial Support of NICU Parents through Staff Education and Support

Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents’ functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby

Systematic meta-review of supported self-management for asthma: a healthcare perspective

BACKGROUND: Supported self-management has been recommended by asthma guidelines for three decades; improving current suboptimal implementation will require commitment from professionals, patients and healthcare organisations. The Practical Systematic Review of Self-Management Support (PRISMS) meta-review and Reducing Care Utilisation through Self-management Interventions (RECURSIVE) health economic review were commissioned to provide a systematic overview of supported self-management to inform implementation. We sought to investigate if supported asthma self-management reduces use of healthcare resources and improves asthma control; for which target groups it works; and which components and contextual factors contribute to effectiveness. Finally, we investigated the costs to healthcare services of providing supported self-management. METHODS: We undertook a meta-review (systematic overview) of systematic reviews updated with randomised controlled trials (RCTs) published since the review search dates, and health economic meta-analysis of RCTs. Twelve electronic databases were searched in 2012 (updated in 2015; pre-publication update January 2017) for systematic reviews reporting RCTs (and update RCTs) evaluating supported asthma self-management. We assessed the quality of included studies and undertook a meta-analysis and narrative synthesis. RESULTS: A total of 27 systematic reviews (n = 244 RCTs) and 13 update RCTs revealed that supported self-management can reduce hospitalisations, accident and emergency attendances and unscheduled consultations, and improve markers of control and quality of life for people with asthma across a range of cultural, demographic and healthcare settings. Core components are patient education, provision of an action plan and regular professional review. Self-management is most effective when delivered in the context of proactive long-term condition management. The total cost (n = 24 RCTs) of providing self-management support is offset by a reduction in hospitalisations and accident and emergency visits (standard mean difference 0.13, 95% confidence interval -0.09 to 0.34). CONCLUSIONS: Evidence from a total of 270 RCTs confirms that supported self-management for asthma can reduce unscheduled care and improve asthma control, can be delivered effectively for diverse demographic and cultural groups, is applicable in a broad range of clinical settings, and does not significantly increase total healthcare costs. Informed by this comprehensive synthesis of the literature, clinicians, patient-interest groups, policy-makers and providers of healthcare services should prioritise provision of supported self-management for people with asthma as a core component of routine care. SYSTEMATIC REVIEW REGISTRATION: RECURSIVE: PROSPERO CRD42012002694 ; PRISMS: PROSPERO does not register meta-reviews