Community organizing and community health:Piloting an innovative approach to community engagement applied to an early intervention project in south London

BACKGROUND: The importance of community engagement in health is widely recognized, and key themes in UK National Institute for Health and Clinical Excellence (NICE) recommendations for enhancing community engagement are co-production and community control. This study reports an innovative approach to community engagement using the community-organizing methodology, applied in an intervention of social support to increase social capital, reduce stress and improve well-being in mothers who were pregnant and/or with infants aged 0–2 years. METHODS: Professional community organizers in Citizens-UK worked with local member civic institutions in south London to facilitate social support to a group of 15 new mothers. Acceptability of the programme, adherence to principles of co-production and community control, and changes in the outcomes of interest were assessed quantitatively in a quasi-experimental design. RESULTS: The programme was found to be feasible and acceptable to participating mothers, and perceived by them to involve co-production and community control. There were no detected changes in subjective well-being, but there were important reductions in distress on a standard self-report measure (GHQ-12). There were increases in social capital of a circumscribed kind associated with the project. CONCLUSIONS: Community organizing provides a promising model and method of facilitating community engagement in health

The influence of cannabis smoke and cannabis vapour on simulated lung surfactant function under physiologically relevant conditions

The use of cannabis for medicinal/recreational purposes is widespread throughout the world. Smoke inhalation is known to cause airway irritation due to noxious substances (ie, benzene) within the mix. Thus, advanced vaporisation platforms (eg, Davinci IQ) have been developed to circumvent negative health implications. Here, we consider the impact that cannabis smoke and cannabis vapour have on simulated lung surfactant performance within a model pulmonary space (ie, 37°C, elevated humidity and related fluid hydrodynamics). In total, 50 mg of herbal material was ignited or placed within a Davinci IQ vaporiser with subsequent activation. The aliquots were collected and then analysed using gas chromatography‐mass spectroscopy for composition and cannabinoid (eg, Δ9‐tetrahydrocannabinol [Δ9‐THC]) concentration. The average content within cannabis smoke was 2.84% (0.07%, SD) Δ9‐THC, with the same for cannabis vapour being 0.88% (0.14%, SD). Aerosolised samples were transferred to the lung biosimulator. When compared with the pristine Curosurf system, challenge with cannabis smoke and cannabis vapour reduced the surface pressure term by 26% and 7% and increased film compressibility by 60% and 15% at 80% trough area, respectively. The net effect would be enhanced film elasticity and an increased work of breathing, being more pronounced on cannabis smoke inhalation. The trends noted were ascribed to two factors operating synergistically, namely the amount of Δ9‐THC (plus others) within the aerosolised samples and the associated toxicity profile. Further research is required to establish mass‐balance effects (ie, titrated outputs) along with detailed chemical profiling of material generated from the unrelated cannabis activation pathways

Early mortality and loss to follow-up in HIV-infected children starting antiretroviral therapy in Southern Africa.

BACKGROUND: Many HIV-infected children in Southern Africa have been started on antiretroviral therapy (ART), but loss to follow up (LTFU) can be substantial. We analyzed mortality in children retained in care and in all children starting ART, taking LTFU into account. PATIENTS AND METHODS: Children who started ART before the age of 16 years in 10 ART programs in South Africa, Malawi, Mozambique, and Zimbabwe were included. Risk factors for death in the first year of ART were identified in Weibull models. A meta-analytic approach was used to estimate cumulative mortality at 1 year. RESULTS: Eight thousand two hundred twenty-five children (median age 49 months, median CD4 cell percent 11.6%) were included; 391 (4.8%) died and 523 (7.0%) were LTFU in the first year. Mortality at 1 year was 4.5% [95% confidence interval (CI): 2.8% to 7.4%] in children remaining in care, but 8.7% (5.4% to 12.1%) at the program level, after taking mortality in children and LTFU into account. Factors associated with mortality in children remaining in care included age [adjusted hazard ratio (HR) 0.37; 95% CI: 0.25 to 0.54 comparing > or =120 months with <18 months], CD4 cell percent (HR: 0.56; 95% CI: 0.39 to 0.78 comparing > or =20% with <10%), and clinical stage (HR: 0.12; 95% CI: 0.03 to 0.45 comparing World Health Organization stage I with III/IV). CONCLUSIONS: In children starting ART and remaining in care in Southern Africa mortality at 1 year is <5% but almost twice as high at the program level, when taking LTFU into account. Age, CD4 percentage, and clinical stage are important predictors of mortality at the individual level

Luminous Satellites of Early-Type Galaxies I: Spatial Distribution

We study the spatial distribution of faint satellites of intermediate redshift (0.1<z<0.8), early-type galaxies, selected from the GOODS fields. We combine high resolution HST images and state-of-the-art host subtraction techniques to detect satellites of unprecedented faintness and proximity to intermediate redshift host galaxies (up to 5.5 magnitudes fainter and as close as 0."5/2.5 kpc to the host centers). We model the spatial distribution of objects near the hosts as a combination of an isotropic, homogenous background/foreground population and a satellite population with a power law radial profile and an elliptical angular distribution. We detect a significant population of satellites, Ns =1.7 (+0.9,-0.8) that is comparable to the number of Milky Way satellites with similar host-satellite contrast.The average projected radial profile of the satellite distribution is isothermal, gamma_p= -1.0(+0.3,-0.4), which is consistent with the observed central mass density profile of massive early-type galaxies. Furthermore, the satellite distribution is highly anisotropic (isotropy is ruled out at a >99.99% confidence level). Defining phi to be the offset between the major axis of the satellite spatial distribution and the major axis of the host light profile, we find a maximum posterior probability of phi = 0 and |phi| less than 42 degrees at the 68% confidence level. The alignment of the satellite distribution with the light of the host is consistent with simulations, assuming that light traces mass for the host galaxy as observed for lens galaxies. The anisotropy of the satellite population enhances its ability to produce the flux ratio anomalies observed in gravitationally lensed quasars.Comment: 21 pages, 16 figures, Accepted for publication in Ap

Strong lens search in the ESO public Survey KiDS

We have started a systematic search of strong lens candidates in the ESO public survey KiDS based on the visual inspection of massive galaxies in the redshift range $0.1<z<0.5$. As a pilot program we have inspected 100 sq. deg., which overlap with SDSS and where there are known lenses to use as a control sample. Taking advantage of the superb image quality of VST/OmegaCAM, the colour information and accurate model subtracted images, we have found 18 new lens candidates, for which spectroscopic confirmation will be needed to confirm their lensing nature and study the mass profile of the lensing galaxies.Comment: 4 pages, 1 figure, to appear on the refereed Proceeding of the "The Universe of Digital Sky Surveys" conference held at the INAF--OAC, Naples, on 25th-28th november 2014, to be published on Astrophysics and Space Science Proceedings, edited by Longo, Napolitano, Marconi, Paolillo, Iodic

Time-variation of Jupiter's internal magnetic field consistent with zonal wind advection

Determination of the time dependency (secular variation) of a planet’s magnetic field provides a window into understanding the dynamo responsible for generating its field. However, of the six Solar System planets with active dynamos, secular variation has been firmly established only for Earth. Here, we compare magnetic field observations of Jupiter from the Pioneer 10 and 11, Voyager 1 and Ulysses spacecraft (acquired 1973–1992) with a new Juno reference model (JRM09). We find a consistent, systematic change in Jupiter’s field over this 45-year time span, which cannot be explained by changes in the magnetospheric field or by changing the assumed rotation rate of Jupiter. Through a simplified forward model, we find that the inferred change in the field is consistent with advection of the field by Jupiter’s zonal winds, projected down to 93–95% of Jupiter’s radius (where the electrical conductivity of the hydrogen envelope becomes sufficient to advect the field). This result demonstrates that zonal wind interactions with Jupiter’s magnetic field are important and lends independent support to atmospheric and gravitational-field determinations of the profile of Jupiter’s deep winds

The SWELLS Survey. I. A large spectroscopically selected sample of edge-on late-type lens galaxies

The relative contribution of baryons and dark matter to the inner regions of spiral galaxies provides critical clues to their formation and evolution, but it is generally difficult to determine. For spiral galaxies that are strong gravitational lenses, however, the combination of lensing and kinematic observations can be used to break the disk-halo degeneracy. In turn, such data constrain fundamental parameters such as i) the mass density profile slope and axis ratio of the dark matter halo, and by comparison with dark matter-only numerical simulations the modifications imposed by baryons; ii) the mass in stars and therefore the overall star formation efficiency, and the amount of feedback; iii) by comparison with stellar population synthesis models, the normalization of the stellar initial mass function. In this first paper of a series, we present a sample of 16 secure, 1 probable, and 6 possible strong lensing spiral galaxies, for which multi-band high-resolution images and rotation curves were obtained using the Hubble Space Telescope and Keck-II Telescope as part of the Sloan WFC Edge-on Late-type Lens Survey (SWELLS). The sample includes 8 newly discovered secure systems. [abridged] We find that the SWELLS sample of secure lenses spans a broad range of morphologies (from lenticular to late-type spiral), spectral types (quantified by Halpha emission), and bulge to total stellar mass ratio (0.22-0.85), while being limited to M_*>10^{10.5} M_sun. The SWELLS sample is thus well-suited for exploring the relationship between dark and luminous matter in a broad range of galaxies. We find that the deflector galaxies obey the same size-mass relation as that of a comparison sample of elongated non-lens galaxies selected from the SDSS survey. We conclude that the SWELLS sample is consistent with being representative of the overall population of high-mass high-inclination disky galaxies.Comment: 21 pages, 6 figures, MNRAS, in pres

Integrating HIV treatment with primary care outpatient services: opportunities and challenges from a scaled-up model in Zambia

Background: Integration of HIV treatment with other primary care services has been argued to potentially improve effectiveness, efficiency and equity. However, outside the field of reproductive health, there is limited empirical evidence regarding the scope or depth of integrated HIV programmes or their relative benefits. Moreover,the body of work describing operational models of integrated service-delivery in context remains thin. Between 2008 and 2011, the Lusaka District Health Management Team piloted and scaled-up a model of integrated HIV and general outpatient department (OPD) services in 12 primary health care clinics. This paper examines the effect of the integrated model on the organization of clinic services, and explores service providers' perceptions of the integrated model. Methods: We used a mixed methods approach incorporating facility surveys and key informant interviews with clinic managers and district officials. On-site facility surveys were carried out in 12 integrated facilities to collect data on the scope of integrated services, and 15 semi-structured interviews were carried out with 12 clinic managers and three district officials to explore strengths and weaknesses of the model. Quantitative and qualitative data were triangulated to inform overall analysis. Findings: Implementation of the integrated model substantially changed the organization of service delivery across a range of clinic systems. Organizational and managerial advantages were identified, including more efficient use of staff time and clinic space, improved teamwork and accountability, and more equitable delivery of care to HIV and non-HIV patients. However, integration did not solve ongoing human resource shortages or inadequate infrastructure, which limited the efficacy of the model and were perceived to undermine service delivery. Conclusion: While resource and allocative efficiencies are associated with this model of integration, a more important finding was the model's demonstrated potential for strengthening organizational culture and staff relationships, in turn facilitating more collaborative and motivated service delivery in chronically under-resourced primary healthcare clinics

Bayesian Strong Gravitational-Lens Modeling on Adaptive Grids: Objective Detection of Mass Substructure in Galaxies

We introduce a new adaptive and fully Bayesian grid-based method to model strong gravitational lenses with extended images. The primary goal of this method is to quantify the level of luminous and dark-mass substructure in massive galaxies, through their effect on highly-magnified arcs and Einstein rings. The method is adaptive on the source plane, where a Delaunay tessellation is defined according to the lens mapping of a regular grid onto the source plane. The Bayesian penalty function allows us to recover the best non-linear potential-model parameters and/or a grid-based potential correction and to objectively quantify the level of regularization for both the source and the potential. In addition, we implement a Nested-Sampling technique to quantify the errors on all non-linear mass model parameters -- ... -- and allow an objective ranking of different potential models in terms of the marginalized evidence. In particular, we are interested in comparing very smooth lens mass models with ones that contain mass-substructures. The algorithm has been tested on a range of simulated data sets, created from a model of a realistic lens system. One of the lens systems is characterized by a smooth potential with a power-law density profile, twelve include a NFW dark-matter substructure of different masses and at different positions and one contains two NFW dark substructures with the same mass but with different positions. Reconstruction of the source and of the lens potential for all of these systems shows the method is able, in a realistic scenario, to identify perturbations with masses >=10^7 solar mass when located on the Einstein ring. For positions both inside and outside of the ring, masses of at least 10^9 solar mass are required (...).Comment: 21 pages, 15 figures, 4 tables; accepted for publication in MNRA