High Effective Coverage of Vector Control Interventions in Children After Achieving Low Malaria Transmission in Zanzibar, Tanzania.

\ud \ud Formerly a high malaria transmission area, Zanzibar is now targeting malaria elimination. A major challenge is to avoid resurgence of malaria, the success of which includes maintaining high effective coverage of vector control interventions such as bed nets and indoor residual spraying (IRS). In this study, caretakers' continued use of preventive measures for their children is evaluated, following a sharp reduction in malaria transmission. A cross-sectional community-based survey was conducted in June 2009 in North A and Micheweni districts in Zanzibar. Households were randomly selected using two-stage cluster sampling. Interviews were conducted with 560 caretakers of under-five-year old children, who were asked about perceptions on the malaria situation, vector control, household assets, and intention for continued use of vector control as malaria burden further decreases. Effective coverage of vector control interventions for under-five children remains high, although most caretakers (65%; 363/560) did not perceive malaria as presently being a major health issue. Seventy percent (447/643) of the under-five children slept under a long-lasting insecticidal net (LLIN) and 94% (607/643) were living in houses targeted with IRS. In total, 98% (628/643) of the children were covered by at least one of the vector control interventions. Seasonal bed-net use for children was reported by 25% (125/508) of caretakers of children who used bed nets. A high proportion of caretakers (95%; 500/524) stated that they intended to continue using preventive measures for their under-five children as malaria burden further reduces. Malaria risk perceptions and different perceptions of vector control were not found to be significantly associated with LLIN effective coverage While the majority of caretakers felt that malaria had been reduced in Zanzibar, effective coverage of vector control interventions remained high. Caretakers appreciated the interventions and recognized the value of sustaining their use. Thus, sustaining high effective coverage of vector control interventions, which is crucial for reaching malaria elimination in Zanzibar, can be achieved by maintaining effective delivery of these interventions

Supporting self-management for patients with Interstitial Lung Diseases:Utility and acceptability of digital devices

INTRODUCTION: Patients diagnosed with Interstitial Lung Diseases (ILD) use devices to self-monitor their health and well-being. Little is known about the range of devices, selection, frequency and terms of use and overall utility. We sought to quantify patients' usage and experiences with home digital devices, and further evaluate their perceived utility and barriers to adaptation.METHODS: A team of expert clinicians and patient partners interested in self-management approaches designed a 48-question cross-sectional electronic survey; specifically targeted at individuals diagnosed with ILD. The survey was critically appraised by the interdisciplinary self-management group at Royal Devon University Hospitals NHS Foundation Trust during a 6-month validation process. The survey was open for participation between September 2021 and December 2022, and responses were collected anonymously. Data were analysed descriptively for quantitative aspects and through thematic analysis for qualitative input.RESULTS: 104 patients accessed the survey and 89/104 (86%) reported a diagnosis of lung fibrosis, including 46/89 (52%) idiopathic pulmonary fibrosis (IPF) with 57/89 (64%) of participants diagnosed &gt;3 years and 59/89 (66%) female. 52/65(80%) were in the UK; 33/65 (51%) reported severe breathlessness medical research council MRC grade 3-4 and 32/65 (49%) disclosed co-morbid arthritis or joint problems. Of these, 18/83 (22%) used a hand- held spirometer, with only 6/17 (35%) advised on how to interpret the readings. Pulse oximetry devices were the most frequently used device by 35/71 (49%) and 20/64 (31%) measured their saturations more than once daily. 29/63 (46%) of respondents reported home-monitoring brought reassurance; of these, for 25/63 (40%) a feeling of control. 10/57 (18%) felt it had a negative effect, citing fluctuating readings as causing stress and 'paranoia'. The most likely help-seeking triggers were worsening breathlessness 53/65 (82%) and low oxygen saturation 43/65 (66%). Nurse specialists were the most frequent source of help 24/63 (38%). Conclusion: Patients can learn appropriate technical skills, yet perceptions of home-monitoring are variable; targeted assessment and tailored support is likely to be beneficial.</p

PSICOLOGIA EM LINK: PROJETO DE ESCUTA PSICOLÓGICA ONLINE EM TEMPOS DE PANDEMIA

O presente artigo tem como objetivo principal relatar a experiência da ação extensionista Psicologia em Link, criada para desenvolver um espaço de escuta e acolhimento psicológico de forma online durante o período de afastamento social na pandemia da COVID-19 no ano de 2020. O atendimento online é uma modalidade reconhecida e regulamentada pelo sistema conselhos de Psicologia. Este projeto foi implantado diante da impossibilidade da realização dos atendimentos presenciais, a partir de estudos recentes sobre saúde mental em tempos de distanciamento social e sobre o próprio atendimento online. Todos os atendimentos foram realizados virtualmente através de plataformas de vídeo conferências (Skype, Google Meet) e para divulgação e acesso ao projeto foram utilizadas redes sociais como o WhatsApp e o Instagram. Apontamos que, nesse contexto, a universidade pública assume um importante papel ao não se eximir em devolver à comunidade externa os investimentos realizados ao contribuir no esforço de redução do sofrimento mental da população, além de atender ao fundamento da indissociabilidade entre ensino, pesquisa e extensão. Desde o planejamento até a prática, a ação apresentou desafios que conduziram à produção de conhecimento, experiência e possibilidade de atendimento a diversos públicos. Os atendimentos nas modalidades online têm oferecido perspectivas positivas e relevantes no cuidado e minimização de danos em situações de urgência. Apesar dos desafios encontrados durante a experiência, ressalta-se, neste relato, a validade e o impacto da ação para toda a comunidade, incluindo, também, a formação dos alunos extensionistas envolvidos, atentos às novas modalidades, às diversas realidades e às &nbsp;demandas sociais

PSICOLOGIA EM LINK: PROJETO DE ESCUTA PSICOLÓGICA ONLINE EM TEMPOS DE PANDEMIA

O presente artigo tem como objetivo principal relatar a experiência da ação extensionista Psicologia em Link, criada para desenvolver um espaço de escuta e acolhimento psicológico de forma online durante o período de afastamento social na pandemia da COVID-19 no ano de 2020. O atendimento online é uma modalidade reconhecida e regulamentada pelo sistema conselhos de Psicologia. Este projeto foi implantado diante da impossibilidade da realização dos atendimentos presenciais, a partir de estudos recentes sobre saúde mental em tempos de distanciamento social e sobre o próprio atendimento online. Todos os atendimentos foram realizados virtualmente através de plataformas de vídeo conferências (Skype, Google Meet) e para divulgação e acesso ao projeto foram utilizadas redes sociais como o WhatsApp e o Instagram. Apontamos que, nesse contexto, a universidade pública assume um importante papel ao não se eximir em devolver à comunidade externa os investimentos realizados ao contribuir no esforço de redução do sofrimento mental da população, além de atender ao fundamento da indissociabilidade entre ensino, pesquisa e extensão. Desde o planejamento até a prática, a ação apresentou desafios que conduziram à produção de conhecimento, experiência e possibilidade de atendimento a diversos públicos. Os atendimentos nas modalidades online têm oferecido perspectivas positivas e relevantes no cuidado e minimização de danos em situações de urgência. Apesar dos desafios encontrados durante a experiência, ressalta-se, neste relato, a validade e o impacto da ação para toda a comunidade, incluindo, também, a formação dos alunos extensionistas envolvidos, atentos às novas modalidades, às diversas realidades e às  demandas sociais

The impact of mixing treatments on cloud modelling in 3D simulations of hot Jupiters

This is the author accepted manuscript. The final version is available from Oxford University Press via the DOI in this recordData availability: The research data supporting this publication are openly available at https://doi.org/10.7910/DVN/NLT6MSWe present results of 3D hydrodynamical simulations of HD209458b including a coupled, radiatively-active cloud model (EddySed). We investigate the role of the mixing by replacing the default convective treatment used in previous works with a more physically relevant mixing treatment ( ) based on global circulation. We find that uncertainty in the efficiency of sedimentation through the sedimentation factor sed plays a larger role in shaping cloud thickness and its radiative feedback on the local gas temperatures – e.g. hot spot shift and day-to-night side temperature gradient – than the switch in mixing treatment. We demonstrate using our new mixing treatments that simulations with cloud scales which are a fraction of the pressure scale height improve agreement with the observed transmission spectra, the emission spectra, and the Spitzer 4.5 m phase curve, although our models are still unable to reproduce the optical and UV transmission spectra. We also find that the inclusion of cloud increases the transit asymmetry in the optical between the east and west limbs, although the difference remains small (. 1%).Leverhulme TrustScience and Technology Facilities Council (STFC)Medical Research Council (MRC

Social research on neglected diseases of poverty: Continuing and emerging themes

Copyright: © 2009 Manderson et al.Neglected tropical diseases (NTDs) exist and persist for social and economic reasons that enable the vectors and pathogens to take advantage of changes in the behavioral and physical environment. Persistent poverty at household, community, and national levels, and inequalities within and between sectors, contribute to the perpetuation and re-emergence of NTDs. Changes in production and habitat affect the physical environment, so that agricultural development, mining and forestry, rapid industrialization, and urbanization all result in changes in human uses of the environment, exposure to vectors, and vulnerability to infection. Concurrently, political instability and lack of resources limit the capacity of governments to manage environments, control disease transmission, and ensure an effective health system. Social, cultural, economic, and political factors interact and influence government capacity and individual willingness to reduce the risks of infection and transmission, and to recognize and treat disease. Understanding the dynamic interaction of diverse factors in varying contexts is a complex task, yet critical for successful health promotion, disease prevention, and disease control. Many of the research techniques and tools needed for this purpose are available in the applied social sciences. In this article we use this term broadly, and so include behavioral, population and economic social sciences, social and cultural epidemiology, and the multiple disciplines of public health, health services, and health policy and planning. These latter fields, informed by foundational social science theory and methods, include health promotion, health communication, and heath education

Patterns and drivers of tree Mortality in Iberian Forests: climatic effects are modified by competition

Tree mortality is a key process underlying forest dynamics and community assembly. Understanding how tree mortality is driven by simultaneous drivers is needed to evaluate potential effects of climate change on forest composition. Using repeat-measure information fromc.400,000 trees from the Spanish Forest Inventory, we quantified the relative importance of tree size, competition, climate and edaphic conditions on tree mortality of 11 species, and explored the combined effect of climate and competition. Tree mortality was affected by all of these multiple drivers, especially tree size and asymmetric competition, and strong interactions between climate and competition were found. All species showed L-shaped mortality patterns (i.e. showed decreasing mortality with tree size), but pines were more sensitive to asymmetric competition than broadleaved species. Among climatic variables, the negative effect of temperature on tree mortality was much larger than the effect of precipitation. Moreover, the effect of climate (mean annual temperature and annual precipitation) on tree mortality was aggravated at high competition levels for all species, but especially for broadleaved species. The significant interaction between climate and competition on tree mortality indicated that global change in Mediterranean regions, causing hotter and drier conditions and denser stands, could lead to profound effects on forest structure and composition. Therefore, to evaluate the potential effects of climatic change on tree mortality, forest structure must be considered, since two systems of similar composition but different structure could radically differ in their response to climatic conditions

Supporting self-management for patients with Interstitial Lung Diseases: Utility and acceptability of digital devices.

This is the final version. Available from Public Library of Science via the DOI in this record. Data Availability Statement: The fully de-identified research data supporting this publication are openly available as S1 Data and at 10.6084/m9. figshare.24569851.INTRODUCTION: Patients diagnosed with Interstitial Lung Diseases (ILD) use devices to self-monitor their health and well-being. Little is known about the range of devices, selection, frequency and terms of use and overall utility. We sought to quantify patients' usage and experiences with home digital devices, and further evaluate their perceived utility and barriers to adaptation. METHODS: A team of expert clinicians and patient partners interested in self-management approaches designed a 48-question cross-sectional electronic survey; specifically targeted at individuals diagnosed with ILD. The survey was critically appraised by the interdisciplinary self-management group at Royal Devon University Hospitals NHS Foundation Trust during a 6-month validation process. The survey was open for participation between September 2021 and December 2022, and responses were collected anonymously. Data were analysed descriptively for quantitative aspects and through thematic analysis for qualitative input. RESULTS: 104 patients accessed the survey and 89/104 (86%) reported a diagnosis of lung fibrosis, including 46/89 (52%) idiopathic pulmonary fibrosis (IPF) with 57/89 (64%) of participants diagnosed >3 years and 59/89 (66%) female. 52/65(80%) were in the UK; 33/65 (51%) reported severe breathlessness medical research council MRC grade 3-4 and 32/65 (49%) disclosed co-morbid arthritis or joint problems. Of these, 18/83 (22%) used a hand- held spirometer, with only 6/17 (35%) advised on how to interpret the readings. Pulse oximetry devices were the most frequently used device by 35/71 (49%) and 20/64 (31%) measured their saturations more than once daily. 29/63 (46%) of respondents reported home-monitoring brought reassurance; of these, for 25/63 (40%) a feeling of control. 10/57 (18%) felt it had a negative effect, citing fluctuating readings as causing stress and 'paranoia'. The most likely help-seeking triggers were worsening breathlessness 53/65 (82%) and low oxygen saturation 43/65 (66%). Nurse specialists were the most frequent source of help 24/63 (38%). Conclusion: Patients can learn appropriate technical skills, yet perceptions of home-monitoring are variable; targeted assessment and tailored support is likely to be beneficial.Health Education Englan