Willingness to pay for WASH education services: a case study in Honduras

Many organizations provide education and training services to improve the sustainability of water, sanitation and hygiene (WASH) interventions; however, it can be challenging to develop financially sustainable models for delivering such services. To address this, the University of Cambridge, the Centre for Affordable Water and Sanitation Technology, and Agua Pura Para el Mundo (APPM) completed a Willingness to Pay (WTP) study for WASH education services in Honduras. Rural community members had some WTP for education services, despite low income levels, and preferred when a product, e.g. a water filter, was provided as well. Individual WASH practitioners had moderate WTP (~25% of cost) for short courses. Organisations had relatively high WTP, compared with the other two groups (~50% of cost). The results were used to investigate potentially sustainable business models for APPM’s education services. The methodology presented can support other organizations to develop sustainable business approaches for their capacity development services

Doping, European Law and the Implications of Meca-Medina

The ruling of the European Court of Justice in the anti-doping case of Meca Medina v. The Commission has important implications for athletes, domestic governing bodies, international federations and supra-national actors such as WADA and the Court of Arbitration for Sport. Meca-Medina has been criticised as an unwelcome interference by the courts in the legitimate activities of sporting organisations, but after Bosman it was fanciful to argue that those organisations should be ‘above the law’ and the courts should have no jurisdiction over their activities. That said, there is a stark difference between the courts having jurisdiction over sports’ decisions and being willing to overturn them - the courts have been, and remain, willing to defer to the expertise of sporting organisations. However, the ECJ’s ruling in MOTOE confirms that the courts will intervene in appropriate circumstances. In order to avoid sanction on competition law grounds sports organisations must thus be able to justify their provisions on (for example) what is an unacceptable level of nandrolone, show that athletes’ fundamental rights such as the right to a fair hearing have been respected, and ensure that any sanctions imposed upon athletes who fall foul of doping regulations are proportionate to the offence committed

Technological development of the OGRE focal plane array

The Off-plane Grating Rocket Experiment (OGRE) is a high resolution soft X-ray spectrometer sub-orbital rocket payload designed as a technology development platform for three low Technology Readiness Level (TRL) components. The incident photons will be focused using a light-weight, high resolution, single-crystal silicon optic. They are then dispersed conically according to wavelength by an array of off-plane gratings before being detected in a focal plane camera comprised of four Electron Multiplying Charge-Coupled Devices (EM-CCDs). While CCDs have been extensively used in space applications; EM-CCDs are seldom used in this environment and even more rarely for X-ray photon counting applications, making them a potential technology risk for larger scale X-ray observatories. This paper will discuss the reasons behind choosing EM-CCDs for the focal plane detector and the developments that have been recently made in the prototype camera electronics and thermal control system

The Medecins Sans Frontieres Intervention in the Marburg Hemorrhagic Fever Epidemic, Uige, Angola, 2005. I. Lessons Learned in the Hospital.

When the epidemic of Marburg hemorrhagic fever occurred in Uige, Angola, during 2005, the international response included systems of case detection and isolation, community education, the burial of the dead, and disinfection. However, despite large investments of staff and money by the organizations involved, only a fraction of the reported number of cases were isolated, and many cases were detected only after death. This article describes the response of Medecins Sans Frontieres Spain within the provincial hospital in Uige, as well as the lessons they learned during the epidemic. Diagnosis, management of patients, and infection control activities in the hospital are discussed. To improve the acceptability of the response to the host community, psychological and cultural factors need to be considered at all stages of planning and implementation in the isolation ward. More interventional medical care may not only improve survival but also improve acceptability

Fast slow folding of an outer membrane porin

In comparison to globular proteins, the spontaneous folding and insertion of β-barrel membrane proteins are surprisingly slow, typically occurring on the order of minutes. Using single-molecule Förster resonance energy transfer to report on the folding of fluorescently labeled outer membrane protein G we measured the real-time insertion of a β-barrel membrane protein from an unfolded state. Folding events were rare and fast (<20 ms), occurring immediately upon arrival at the membrane. This combination of infrequent, but rapid, folding resolves this apparent dichotomy between slow ensemble kinetics and the typical timescales of biomolecular folding

Patient and public involvement workshop to shape artificial intelligence-supported connected asthma self-management research

Digital interventions with artificial intelligence (AI) can potentially support people with asthma to reduce the risk of exacerbation. Engaging patients throughout the development process is essential to ensure usability of the intervention for the end-users. Using our Connected for Asthma (C4A) intervention as an exemplar, we explore how patient involvement can shape a digital intervention. Seven Patient and Public Involvement (PPI) colleagues from the Asthma UK Centre for Applied Research participated in four advisory workshops to discuss how they would prefer to use/interact with AI to support living with their asthma, the benefit and caveats to use the AI that incorporated asthma monitoring and indoor/outdoor environmental data. Discussion focussed on the three most wanted use cases identified in our previous studies. PPI colleagues wanted AI to support data collection, remind them about self-management tasks, teach them about asthma environmental triggers, identify risk, and empower them to confidently look after their asthma whilst emphasising that AI does not replace clinicians. The discussion informed the key components in the next C4A interventions, including the approach to interacting with AI, the technology features and the research topics. Attendees highlighted the importance of considering health inequities, the presentation of data, and concerns about data accuracy, data privacy, security and ownership. We have demonstrated how patient roles can shift from that of ‘user’ (the traditional ‘tester’ of a digital intervention), to a co-design partner who shapes the next iteration of the intervention. Technology innovators should seek practical and feasible strategies to involve PPI colleagues throughout the development cycle of a digital intervention; supporting researchers to explore the barriers, concerns, enablers and advantages of implementing digital healthcare.<br/

Development of the X-ray camera for the OGRE sub-orbital rocket

Current theories regarding the matter composition of the universe suggest that half of the expected baryonic matter is missing. One region this could be residing in is intergalactic filaments which absorb strongly in the X-ray regime. Present space based technology is limited when it comes to imaging at these wavelengths and so new techniques are required. The Off-Plane Grating Rocket Experiment (OGRE) aims to produce the highest resolution spectrum of the binary star system Capella, a well-known X-ray source, in the soft X-ray range (0.2keV to 2keV). This will be achieved using a specialised payload combining three low technology readiness level components placed on-board a sub-orbital rocket. These three components consist of an array of large format off-plane X-ray diffraction gratings, a Wolter Type 1 mirror made using single crystal silicon, and the use of EM-CCDs to capture soft X-rays. Each of these components have been previously reviewed with OGRE being the first project to utilise them in a space observation mission. This paper focuses on the EM-CCDs (CCD207-40 by e2v) that will be used and their optimisation with a camera purposely designed for OGRE. Electron Multiplying gain curves were produced for the back-illuminated devices at -80 degrees Celsius. Further tests which will need to be carried out are discussed and the impact of the OGRE mission on future projects mentioned

A low-order unstructured-mesh approach for computational electromagnetics in the time domain

Maxwell&apos;s curl equations in the time domain are solved using an explicit linear finite-element approach implemented on unstructured tetrahedral meshes. For the simulation of scattering problems, a perfectly matched layer is added at the artificial far-field boundary, created by the truncation of the physical domain prior to the numerical solution. The complete solution procedure is parallelized. The computational challenges that are encountered when attempting simulations at higher frequencies suggest that the implementation of a hybrid algorithm could have certain advantages. The hybrid approach adopted uses a combination of the finite-element procedure and the well-known low operation count/low storage finite-difference timedomain method. Examples are included to demonstrate the numerical performance of the techniques that are described

Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomised trial of 45 000 donors

Background: Limits on the frequency of whole blood donation exist primarily to safeguard donor health. However, there is substantial variation across blood services in the maximum frequency of donations allowed. We compared standard practice in the UK with shorter inter-donation intervals used in other countries. Methods: In this parallel group, pragmatic, randomised trial, we recruited whole blood donors aged 18 years or older from 25 centres across England, UK. By use of a computer-based algorithm, men were randomly assigned (1:1:1) to 12-week (standard) versus 10-week versus 8-week inter-donation intervals, and women were randomly assigned (1:1:1) to 16-week (standard) versus 14-week versus 12-week intervals. Participants were not masked to their allocated intervention group. The primary outcome was the number of donations over 2 years. Secondary outcomes related to safety were quality of life, symptoms potentially related to donation, physical activity, cognitive function, haemoglobin and ferritin concentrations, and deferrals because of low haemoglobin. This trial is registered with ISRCTN, number ISRCTN24760606, and is ongoing but no longer recruiting participants. Findings: 45 263 whole blood donors (22 466 men, 22 797 women) were recruited between June 11, 2012, and June 15, 2014. Data were analysed for 45 042 (99·5%) participants. Men were randomly assigned to the 12-week (n=7452) versus 10-week (n=7449) versus 8-week (n=7456) groups; and women to the 16-week (n=7550) versus 14-week (n=7567) versus 12-week (n=7568) groups. In men, compared with the 12-week group, the mean amount of blood collected per donor over 2 years increased by 1·69 units (95% CI 1·59–1·80; approximately 795 mL) in the 8-week group and by 0·79 units (0·69–0·88; approximately 370 mL) in the 10-week group (p&lt;0·0001 for both). In women, compared with the 16-week group, it increased by 0·84 units (95% CI 0·76–0·91; approximately 395 mL) in the 12-week group and by 0·46 units (0·39–0·53; approximately 215 mL) in the 14-week group (p&lt;0·0001 for both). No significant differences were observed in quality of life, physical activity, or cognitive function across randomised groups. However, more frequent donation resulted in more donation-related symptoms (eg, tiredness, breathlessness, feeling faint, dizziness, and restless legs, especially among men [for all listed symptoms]), lower mean haemoglobin and ferritin concentrations, and more deferrals for low haemoglobin (p&lt;0·0001 for each) than those observed in the standard frequency groups. Interpretation: Over 2 years, more frequent donation than is standard practice in the UK collected substantially more blood without having a major effect on donors' quality of life, physical activity, or cognitive function, but resulted in more donation-related symptoms, deferrals, and iron deficiency. Funding: NHS Blood and Transplant, National Institute for Health Research, UK Medical Research Council, and British Heart Foundation

Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study

Objectives We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation and death during the winter period in Scotland. Design A population-based retrospective cohort analysis Setting Scotland Participants 5.4 million residents in Scotland Main outcome measures Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation. Results Between September 1, 2022 and January 31, 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1,759 in children and 20,525 in adults) in Scotland. Compared to the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR=4.55 95%CI (4.11-5.04)). Compared to 25-29 years old, the risk of ARI hospitalisation was highest amongst the oldest adults aged ≥80 years (7.86 (7.06-8.76)). Adults from more deprived areas (most deprived vs least deprived, 1.64 (1.57-1.72)), with existing health conditions (≥5 vs 0 health conditions, 4.84 (4.53-5.18)) or with history of all-cause emergency admissions (≥6 vs 0 previous emergency admissions 7.53 (5.48-10.35)) were at higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children. Conclusions Younger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI