Health-seeking behaviour and community perceptions of childhood undernutrition and a community management of acute malnutrition (CMAM) programme in rural Bihar, India: a qualitative study.

Objective Since 2009, Médecins Sans Frontières has implemented a community management of acute malnutrition (CMAM) programme in rural Biraul block, Bihar State, India that has admitted over 10 000 severely malnourished children but has struggled with poor coverage and default rates. With the aim of improving programme outcomes we undertook a qualitative study to understand community perceptions of childhood undernutrition, the CMAM programme and how these affected health-seeking behaviour

NGC 1068: No change in the mid-IR torus structure despite X-ray variability

Context. Recent NuSTAR observations revealed a somewhat unexpected increase in the X-ray flux of the nucleus of NGC 1068. We expect the infrared emission of the dusty torus to react on the intrinsic changes of the accretion disk. Aims. We aim to investigate the origin of the X-ray variation by investigating the response of the mid-infrared environment. Methods. We obtained single-aperture and interferometric mid-infrared measurements and directly compared the measurements observed before and immediately after the X-ray variations. The average correlated and single-aperture fluxes as well as the differential phases were directly compared to detect a possible change in the structure of the nuclear emission on scales of $\sim$ 2 pc. Results. The flux densities and differential phases of the observations before and during the X-ray variation show no significant change over a period of ten years. Possible minor variations in the infrared emission are $\lesssim$ 8 %. Conclusions. Our results suggest that the mid-infrared environment of NGC 1068 has remained unchanged for a decade. The recent transient change in the X-rays did not cause a significant variation in the infrared emission. This independent study supports previous conclusions that stated that the X-ray variation detected by NuSTAR observations is due to X-ray emission piercing through a patchy section of the dusty region.Comment: 6 pages, 5 figures, 3 tables. Accepted for publication on A&

The complexity of parsec-scaled dusty tori in AGN

Warm gas and dust surround the innermost regions of active galactic nuclei (AGN). They provide the material for accretion onto the super-massive black hole and they are held responsible for the orientation-dependent obscuration of the central engine. The AGN-heated dust distributions turn out to be very compact with sizes on scales of about a parsec in the mid-infrared. Only infrared interferometry currently provides the necessary angular resolution to directly study the physical properties of this dust. Size estimates for the dust distributions derived from interferometric observations can be used to construct a size--luminosity relation for the dust distributions. The large scatter about this relation suggests significant differences between the dust tori in the individual galaxies, even for nuclei of the same class of objects and with similar luminosities. This questions the simple picture of the same dusty doughnut in all AGN. The Circinus galaxy is the closest Seyfert 2 galaxy. Because its mid-infrared emission is well resolved interferometrically, it is a prime target for detailed studies of its nuclear dust distribution. An extensive new interferometric data set was obtained for this galaxy. It shows that the dust emission comes from a very dense, disk-like structure which is surrounded by a geometrically thick, similarly warm dust distribution as well as significant amounts of warm dust within the ionisation cone.Comment: 8 pages, 3 figures, to appear in the proceedings of the conference "The central kiloparsec in Galactic Nuclei: Astronomy at High Angular Resolution 2011", open access Journal of Physics: Conference Series (JPCS), published by IOP Publishin

Dust emission from a parsec-scale structure in the Seyfert 1 nucleus of NGC 4151

We report mid-IR interferometric measurements with \sim 10 mas resolution, which resolve the warm (T = 285 +25 / -50 K) thermal emission at the center of NGC 4151. Using pairs of VLT 8.2 m telescopes with MIDI and by comparing the data to a Gaussian model, we determined the diameter of the dust emission region, albeit only along one position angle, to be 2.0 +/- 0.4 pc (FWHM). This is the first size and temperature estimate for the nuclear warm dust distribution in a Seyfert 1 galaxy. The parameters found are comparable to those in Seyfert 2 galaxies, thus providing direct support for the unified model. Using simple analytic temperature distributions, we find that the mid-infrared emission is probably not the smooth continuation of the hot nuclear source that is marginally resolved with K band interferometry. We also detected weak excess emission around 10.5 micron in our shorter baseline observation, possibly indicating that silicate emission is extended to the parsec scale.Comment: 5 pages, 4 figures, accepted for publication in The Astrophysical Journal Letter

Obscuration in AGNs: near-infrared luminosity relations and dust colors

We combine two approaches to isolate the AGN luminosity at near-infrared wavelengths and relate the near-IR pure AGN luminosity to other tracers of the AGN. Using integral-field spectroscopic data of an archival sample of 51 local AGNs, we estimate the fraction of non-stellar light by comparing the nuclear equivalent width of the stellar 2.3 micron CO absorption feature with the intrinsic value for each galaxy. We compare this fraction to that derived from a spectral decomposition of the integrated light in the central arc second and find them to be consistent with each other. Using our estimates of the near-IR AGN light, we find a strong correlation with presumably isotropic AGN tracers. We show that a significant offset exists between type 1 and type 2 sources in the sense that type 1 sources are 7 (10) times brighter in the near-IR at log L_MIR = 42.5 (log L_X = 42.5). These offsets only becomes clear when treating infrared type 1 sources as type 1 AGNs. All AGNs have very red near-to-mid-IR dust colors. This, as well as the range of observed near-IR temperatures, can be explained with a simple model with only two free parameters: the obscuration to the hot dust and the ratio between the warm and hot dust areas. We find obscurations of A_V (hot) = 5 - 15 mag for infrared type 1 sources and A_V (hot) = 15 - 35 mag for type 2 sources. The ratio of hot dust to warm dust areas of about 1000 is nicely consistent with the ratio of radii of the respective regions as found by infrared interferometry.Comment: 17 pages, 10 Figures, 3 Tables, accepted by A&

Women at Altitude: Sex-Related Physiological Responses to Exercise in Hypoxia.

Sex differences in physiological responses to various stressors, including exercise, have been well documented. However, the specific impact of these differences on exposure to hypoxia, both at rest and during exercise, has remained underexplored. Many studies on the physiological responses to hypoxia have either excluded women or included only a limited number without analyzing sex-related differences. To address this gap, this comprehensive review conducted an extensive literature search to examine changes in physiological functions related to oxygen transport and consumption in hypoxic conditions. The review encompasses various aspects, including ventilatory responses, cardiovascular adjustments, hematological alterations, muscle metabolism shifts, and autonomic function modifications. Furthermore, it delves into the influence of sex hormones, which evolve throughout life, encompassing considerations related to the menstrual cycle and menopause. Among these physiological functions, the ventilatory response to exercise emerges as one of the most sex-sensitive factors that may modify reactions to hypoxia. While no significant sex-based differences were observed in cardiac hemodynamic changes during hypoxia, there is evidence of greater vascular reactivity in women, particularly at rest or when combined with exercise. Consequently, a diffusive mechanism appears to be implicated in sex-related variations in responses to hypoxia. Despite well-established sex disparities in hematological parameters, both acute and chronic hematological responses to hypoxia do not seem to differ significantly between sexes. However, it is important to note that these responses are sensitive to fluctuations in sex hormones, and further investigation is needed to elucidate the impact of the menstrual cycle and menopause on physiological responses to hypoxia

Adaptation in anaesthesia team coordination in response to a simulated critical event and its relationship to clinical performance

Background Recent studies in anaesthesia and intensive care indicate that a team's ability to adapt its coordination activities to changing situational demands is crucial for effective teamwork and thus, safe patient care. This study addresses the relationship between adaptation of team coordination and markers of clinical performance in response to a critical event, particularly regarding which types of coordination activities are used and which team member engages in those coordination activities. Methods Video recordings of 15 two-person anaesthesia teams (anaesthesia trainee plus anaesthesia nurse) performing a simulated induction of general anaesthesia were coded, using a structured observation system for coordination activities. The simulation involved a critical event—asystole during laryngoscopy. Clinical performance was assessed using two separate reaction times related to the critical event. Results Analyses of variance revealed a significant effect of the critical event on team coordination: after the occurrence of the asystole, team members adapted their coordination activities by spending more time on information management—a specific type of coordination activity (F1,28=15.17, P=0.001). No significant effect was found for task management. The increase in information management was related to faster decisions regarding how to respond to the critical event, but only for trainees and not for nurses. Conclusions Our findings support the claim that adaptation of coordination activities is related to improved team performance in healthcare. Moreover, adaptation and its relationship to team performance were found to vary with regard to type of coordination activities and team membe