40 research outputs found

    Comics and human rights: a change is gonna come. Women in the superhero genre

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    Sam LeBas is a comic book editor and journalist from Louisiana. She works with the independent publisher ComixTribe, editing comic books, as well as helping aspiring creators learn about the process of making and publishing comics. In addition to writing comic book reviews and related articles, she is the co-author of a monthly Batgirl column for the Eisner-Nominated site Multiversity Comics. Find her on Twitter as @comicsonice Will Brooker is Professor of Film and Cultural Studies at Kingston University. He has written extensively on comic books and their audiences, and co-authors a column on Batgirl for the Eisner-Nominated site Multiversity Comics. His next book is the co-edited Many More Lives of the Batman, in 2015. He tweets as @willbrooke

    How to (or Not to) Integrate Vertical Programmes for the Control of Major Neglected Tropical Diseases in Sub-Saharan Africa

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    Combining the delivery of multiple health interventions has the potential to minimize costs and expand intervention coverage. Integration of mass drug administration is therefore being encouraged for delivery of preventive chemotherapy (PCT) to control onchocerciasis, lymphatic filariasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma in sub-Saharan Africa, as there is considerable geographical overlap of these neglected tropical diseases (NTDs). With only a handful of countries having embarked on integrated NTD control, experience on how to develop and implement an efficient integrated programme is limited. Historically, national and global programmes were focused on the control of only one disease, usually through a comprehensive approach that involved several interventions including PCT. Overcoming the resulting disease-specific structures and thinking, and ensuring that the integrated programme is embedded within the existing health structures, pose considerable challenges to policy makers and implementers wishing to embark on integrated NTD control. By sharing experiences from Uganda, Tanzania, Southern Sudan, and Mozambique, this symposium article aims to outlines key challenges and solutions to assist countries in establishing efficient integrated NTD programmes

    Is lifetime traumatic brain injury a risk factor for mild cognitive impairment in veterans compared to non-veterans?

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    Data availability statement: Owing to the nature of the research, for ethical reasons supporting data are not available.Supplemental data for this article can be accessed online at: https://doi.org/10.1080/20008066.2023.2291965 .Copyright . Background: Traumatic brain injury (TBI) is prevalent in veterans and may occur at any stages of their life (before, during, or after military service). This is of particular concern, as previous evidence in the general population has identified TBI as a strong risk factor for mild cognitive impairment (MCI), a known precursor of dementia. Objectives: This study aimed to investigate whether exposure to at least one TBI across the lifetime was a risk factor for MCI in ageing UK veterans compared to non-veterans. Method: This cross-sectional study comprised of data from PROTECT, a cohort study comprising UK veterans and non-veterans aged ≥ 50 years at baseline. Veteran and TBI status were self-reported using the Military Service History Questionnaire (MSHQ) and the Brain Injury Screening Questionnaire (BISQ), respectively. MCI was the outcome of interest, and was defined as subjective cognitive impairment and objective cognitive impairment. Results: The sample population comprised of veterans (n = 701) and non-veterans (n = 12,389). TBI was a significant risk factor for MCI in the overall sample (OR = 1.21, 95% CI 1.11–1.31) compared to individuals without TBI. The prevalence of TBI was significantly higher in veterans compared to non-veterans (69.9% vs 59.5%, p < .001). There was no significant difference in the risk of MCI between veterans with TBI and non-veterans with TBI (OR = 1.19, 95% CI 0.98–1.45). Conclusion: TBI remains an important risk factor for MCI, irrespective of veteran status. The clinical implications indicate the need for early intervention for MCI prevention after TBI.Resumen: Antecedentes: El traumatismo encéfalocraneano (TEC) es frecuente en veteranos, el cual puede ocurrir en cualquier etapa de sus vidas (antes, durante o después del servicio militar). Esto es motivo de preocupación, ya que evidencia previa en la población general ha identificado al TEC como un fuerte factor de riesgo de Deterioro Cognitivo Leve (DCL), un precursor conocido de demencia. Objetivo: Este estudio tuvo como objetivo investigar si la exposición a al menos un Traumatismo encéfalocraneano a lo largo de la vida era un factor de riesgo de Deterioro Cognitivo Leve en veteranos del Reino Unido en comparación con no veteranos. Método: Este estudio de corte transversal incluyó datos de PROTECT, un estudio de cohorte que incluye a veteranos y no veteranos del Reino Unido de ≥50 años al inicio del estudio. El estatus de veterano y de Traumatismo encéfalocraneano (TEC) se auto-reportaron utilizando el Cuestionario de Historia de Servicio Militar (MSHQ, por sus siglas en inglés) y el Cuestionario de Detección de Traumatismo encéfalocraneano (BISQ, por sus siglas en inglés), respectivamente. El Deterioro Cognitivo Leve (DCL) fue el resultado de interés, definido como deterioro cognitivo subjetivo y deterioro cognitivo objetivo. Resultados: La muestra poblacional incluyó a veteranos (n = 701) y no veteranos (n = 12.389). El Traumatismo encéfalocraneano (TEC) fue un factor de riesgo significativo de Deterioro Cognitivo Leve (DCL) en la muestra total (OR = 1.21, IC del 95% 1.11–1.31) en comparación con individuos sin TEC. La prevalencia de TEC fue significativamente mayor en veteranos en comparación con no veteranos (69.9% vs 59.5%, p < .001). No hubo diferencia significativa en el riesgo de DCL entre veteranos con TEC y no veteranos con TEC (OR = 1.19, IC del 95% 0.98–1.45). Conclusión: El Traumatismo encéfalocraneano (TEC) continúa siendo un factor de riesgo significativo de Deterioro Cognitivo Leve (DCL), independiente del estatus de veterano. Las implicaciones clínicas sugieren la necesidad de intervenciones tempranas para la prevención de DCL después de un TEC.PhD studentship by the Alzheimer’s Society (award no. 475 [AS-PhD-18b-002]). The PROTECT study was externally funded/supported by the National Institute of Health and Care Research, Exeter Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The Family History of Neurological Disease Questionnaire was funded in part by the Alzheimer’s Research UK South West Network

    Cardiovascular and lifestyle risk factors of mild cognitive impairment in UK veterans and non-veterans

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    Acknowledgement: We thank all volunteers who participated in the PROTECT study.Key learning points: What is already known about this subject: · Previous evidence in the general population has shown exposure to cardiovascular health, or lifestyle choices, are modifiable risk factors for mild cognitive impairment. · This is concerning as veterans are at an increased risk of cardiovascular health or lifestyle factors. This could potentially have a negative consequence on their cognitive function with age. What this study adds: · This is the first study to quantify the risk of mild cognitive impairment in UK veterans exposed to nine key cardiovascular health and lifestyle risk factors compared to the non-veteran population using longitudinal data. · Obesity, alcohol consumption and physical inactivity reduced the risk of mild cognitive impairment in veterans compared to non-veterans. · Within the veteran sample, diabetes and high cholesterol increased the risk of mild cognitive impairment. What impact this may have on practice or policy: · Early diagnosis and intervention of modifiable risk factors may reduce the risk of mild cognitive impairment and subsequently dementia in both veterans and non-veterans.Background: The link between poor cardiovascular health (CVH), lifestyle and mild cognitive impairment (MCI) has been well established in the general population. However, there is limited research exploring these associations in ageing UK veterans. Aims: This study explored the risk of MCI and its association with nine CVH and lifestyle risk factors (including diabetes, heart disease, high cholesterol, high blood pressure, obesity, stroke, physical inactivity, the frequency of alcohol consumption and smoking) in UK veterans and non-veterans. Methods: This prospective cohort study comprised data from the PROTECT study between 2014 and 2022. Participants comprised of UK military veterans and non-veterans aged ≥50 years at baseline. Veteran status was defined using the Military Service History Questionnaire. CVH and lifestyle risk factors were defined using a combination of self-report measures, medication history or physical measurements. MCI was defined as the presence of subjective and objective cognitive impairment. Results: Based on a sample of 9378 veterans (n = 488) and non-veterans (n = 8890), the findings showed the risk of MCI significantly reduced in veterans with obesity, those who frequently consumed alcohol and were physically inactive compared to non-veterans. The risk of MCI significantly increased in veterans with diabetes (hazards ratio [HR] = 2.22, 95% confidence interval [CI] 1.04–4.75, P ≤ 0.05) or high cholesterol (HR = 3.11, 95% CI 1.64–5.87, P ≤ 0.05) compared to veterans without. Conclusions: This study identified CVH and lifestyle factors of MCI in UK veterans and non-veterans. Further work is needed to understand these associations and the underpinning mechanisms which could determine intervention strategies to reduce the risk of MCI.This study was funded as part of a PhD studentship by Alzheimer’s Society (award no. 475 [AS-PhD-18b-002]). The PROTECT study was externally funded/supported by the National Institute of Health and Care Research Exeter Biomedical Research Centre. The Family History of Neurological Disease Questionnaire was funded in part by the Alzheimer’s Research UK South West Network

    Baseline spatial distribution of malaria prior to an elimination programme in Vanuatu

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    BACKGROUND: The Ministry of Health in the Republic of Vanuatu has implemented a malaria elimination programme in Tafea Province, the most southern and eastern limit of malaria transmission in the South West Pacific. Tafea Province is comprised of five islands with malaria elimination achieved on one of these islands (Aneityum) in 1998. The current study aimed to establish the baseline distribution of malaria on the most malarious of the province's islands, Tanna Island, to guide the implementation of elimination activities. METHODS: A parasitological survey was conducted in Tafea Province in 2008. On Tanna Island there were 4,716 participants from 220 villages, geo-referenced using a global position system. Spatial autocorrelation in observed prevalence values was assessed using a semivariogram. Backwards step-wise regression analysis was conducted to determine the inclusion of environmental and climatic variables into a prediction model. The Bayesian geostatistical logistic regression model was used to predict malaria risk, and associated uncertainty across the island. RESULTS: Overall, prevalence on Tanna was 1.0% for Plasmodium falciparum (accounting for 32% of infections) and 2.2% for Plasmodium vivax (accounting for 68% of infections). Regression analysis showed significant association with elevation and distance to coastline for P. vivax and P. falciparum, but no significant association with NDVI or TIR. Colinearity was observed between elevation and distance to coastline with the later variable included in the final Bayesian geostatistical model for P. vivax and the former included in the final model for P. falciparum. Model validation statistics revealed that the final Bayesian geostatistical model had good predictive ability. CONCLUSION: Malaria in Tanna Island, Vanuatu, has a focal and predominantly coastal distribution. As Vanuatu refines its elimination strategy, malaria risk maps represent an invaluable resource in the strategic planning of all levels of malaria interventions for the island
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