Pteropus voeltzkowi and the Understory: A Study of the Behavioral Impacts of the Pemba Flying Fox on the Vegetation and Soil Quality of Pemba Island

This study examines the impact of Pteropus voeltzkowi , colloquially known as the Pemba Flying Fox, on biodiversity and health of the forest ground layer. Known to serve as reforesters, high concentrations of both fruit seeds and nutrient dense guano are introduced into specific environmental locations due to the bat\u27s behavioral patterns. Working around two roost locations, one in Ngezi Forest and the other at the Kidike conservation site near Mjini Ole, diversity of juvenile vegetation was measured and quantified. In a laboratory setting, soil samples from both sites were analyzed for impacts of guano concentration on soil chemical properties. Results found trends at the Kidike roost site of increased vegetation diversity with roost proximity, while soil analysis indicated a correlation between increased guano concentration and increased soil fertility

Primary Market Research: Its Role In Feaslblllty Studies

Primary market research and sound marketing analysis based on this research can make a significant contribution to the accuracy and usefulness of feasibility studies in planning for travel, leisure, tourism, recreation/entertainment, and hospitality development. The author contends that changes in the marketplace will increase the need for primary marketing research in the future

Patient Experience of Integrated Care within the United Kingdom: A Systematic Review

Introduction Integrated care and patient experience are central to the coordination and delivery of high quality health and social care in the UK, but their joint application is poorly understood. This systematic review aimed to gain an understanding of patient experience within current integrated care services in the UK, and specifically, whether they reflect person-centred coordinated care (PCCC). Methods Following PRISMA, electronic databases (ProQuest, EBSCO and Cochrane Library) were searched from 2012 to 2019 for primary, peer-reviewed literature. Papers were included where patients’ or carers’ experiences of integrated care were reported. Papers were excluded where they focused on acute integrated care interventions, measured experience via satisfaction scores only, or findings lacked sufficient depth to answer the research question. Quality was assessed using Mixed Methods Appraisal Tool, and findings synthesised using a framework approach, incorporating the Rainbow Model of Integrated Care and Measuring Integrated Care Patient Framework. Results Sixteen studies were included. Person-centred and shared responsibility experiences were most often discussed. Experiences were not always described as positive and some patients experienced a lack of PCCC. Clinical, professional/organisational and functional integration processes were associated with experiencing domains of PCCC. Discussion People with complex needs experience a lack of coordination across teams and wider community resources, and limited associations were made between integration processes and patient experience. Further research which gives context to individual experience, provides greater detail of integration processes and utilises validated patient experience measures of PCCC is required to understand the association between integration processes and domains of PCCC

Ecology of Anopheles (Nyssorhynchus) darlingi Root in the installation area of a hydroelectric scheme on the border between the States of Mato Grosso do Sul and São Paulo

INTRODUÇÃO: Hidrelétricas alteram o fluxo das águas e provocam impactos sobre a composição de mosquitos, justificando-se essa pesquisa. O objetivo da pesquisa foi estudar anofelinos de área sob a influência de um novo lago e avaliar a vulnerabilidade relativa à malária. MÉTODOS: Foram feitas coletas de Anopheles nas margens da Represa Porto Primavera, durante as fases do alagamento até sua cota máxima. Utilizaram-se as técnicas: atrativa humana, de armadilha de Shannon e concha entomológica. Os indicadores Riqueza e Diversidade foram utilizados para medir o impacto. A análise das distribuições temporais foi realizada pelo teste Mann-Whitney, considerando localidade, cota e método de captura como variáveis independentes (α=0,05). RESULTADOS: A densidade de Anopheles darlingi oscilou entre as localidades A, B e C, sendo que os maiores picos foram para B e C. Com a estabilidade do lago, no último nível, evidenciou-se a tendência de redução da densidade de Anopheles darlingi. CONCLUSÕES: Sugere-se que o risco de autoctonia de malária nas proximidades do lago permanece inalterado, ficando o alerta para esporádicas infecções humanas.IINTRODUCTION: Hydroelectric schemes modify the water flow and cause an impact on mosquito composition, thus justifying investigations. The aim of this study was to study anophelines in the area under the influence of a new lake and to evaluate their relative vulnerability to malaria. METHODS: Anopheles specimens were collected from the edges of the Porto Primavera reservoir, during the phases of reservoir filling until its maximum level was reached. The techniques used were attraction to humans, Shannon traps and entomological scoops. The richness and diversity indexes were used to measure the impact. The temporal distribution analysis was performed using the Mann-Whitney test, taking the site, level and capture method as independent variables (α = 0.05). RESULTS: The density of Anopheles darlingi oscillated among the sites A, B and C, and the biggest peaks were located at B and C. After the lake reached its stable maximum level, there was a tendency for the density to decrease. CONCLUSIONS: It is suggested that the risk of autochthonous malaria in the vicinity of the lake remained unchanged, but it is necessary to remain alert regarding sporadic human infections.Brasil - Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Acidentes, envenenamentos e violências como causa de morte dos residentes no município de São Paulo, Brasil

The external causes of death for the residents of São Paulo, Brazil, are described according to mortality rates and ratios for the period 1970 to 1972. These causes of deaths (traffic, home and work accidents, homicides, suicides and all other) were responsible for 10% of the total deaths occurred in that period. The risk of death by external causes for all ages is 3,5 times higher for males (11,33 inhab.) than for females (3,09 inhab.). The death rate for motor vehicle accidents is increasing for both sexes in this period. The mortality rate for children less than one year old is very high and the main contribution was due to home accidents. Among the studied causes of death, homicide was a very important one for males aging 15 years old and over. The mortality ratio by suicide is higher for females than males but the risk of dying is higher for males.Foi estudado o comportamento das mortes violentas de residentes no município de São Paulo, nos anos 1970, 1971 e 1972. Essas causas, que representam, aproximadamente, 10% do total de óbitos ocorridos em cada ano, incluem todos os tipos de acidentes (trânsito, doméstico, do trabalho e outros), os suicídios, homicídios e todas as demais causas externas. Os tipos de morte foram analisados segundo sexo e grupo etário, sendo os resultados apresentados através de mortalidade proporcional e do risco de morrer por essas causas

The Alice Springs Hospital Readmission Prevention Project (ASHRAPP): a randomised control trial

Background: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context. Methods: This randomised control trial compares a tailored, multidimensional transitional care package to usual care. The objective is to evaluate the efficacy of the transitional care package for Indigenous and non-Indigenous Australian patients with chronic diseases at risk of recurrent readmission with the aim of reducing readmission rates and improving transition to primary care in a remote setting. Patients will be recruited from medical and surgical admissions to Alice Springs Hospital and will be followed for 12 months. The primary outcome measure will be number of admissions to hospital with secondary outcomes including number of emergency department presentations, number of ICU admissions, days alive and out of hospital, time to primary care review post discharge and cost-effectiveness. Discussion: Successful transition from hospital to home is important for patients with complex chronic diseases. Evidence suggests that a coordinated transitional care plan can result in a reduction in length of hospital stay and readmission rates for adults with complex medical needs. This will be the first study to evaluate a tailored multidimensional transitional care intervention to prevent readmission in Indigenous and non-Indigenous Australian residents of remote Australia who are frequently admitted to hospital. If demonstrated to be effective it will have implications for the care and management of Indigenous Australians throughout regional and remote Australia and in other remote, culturally and linguistically diverse populations and settings

Talking with the dead: spirit mediumship, affect and embodiment in Stoke-on-Trent

While Spiritualism has attracted much attention in other disciplines, geographers have largely ignored it. However, we agree with Holloway (2006 Enchanted spaces: the seance, affect, and geographies of religion Annals of the Association of American Geographers 96 182–7) that Spiritualism presents conceptual challenges that make it worthy of more attention. As Holloway suggests, the themes of affect, embodiment and materiality are particularly helpful in exploring religious experiences. The focus of this paper is on the practice and experience of spirit mediumship in a Spiritualist setting. In mediumship, a specific challenge is to materialise and embody spirit such that spirit communication feels personal and rings true. For us, this suggests that mediumship is routinely successful both because it can produce accurate messages, which are judged empirically, and also because it produces what we call affectual truths, which are judged tacitly on whether they feel right or not. To account for this, we introduce the idea of intermediumship to describe interactions in the space in-between the medium and the congregation. It is through this space in-between that the affects associated with mediumship emerge, are experienced and are verified. Rather than seeing spirit communication as somehow enchanted or extraordinary, we assert that talking with the dead is predicated on the ordinariness of the experience: that is, that talking with the dead is emblematic of affect and embodiment in everyday life

THE IMPORTANCE OF CONGENITAL MALFORMATIONS AT BIRTH

Introduction: Countries that have overcome high infant mortality rates show, nowadays, concentration of deaths in the neonatal period and, within it, mainly in the first week of life (early neonatal deaths). Regarding causes of death, as some diseases have started to be controlled, a significant proportional increase in the participation of congenital malformations has been verified. Objective: To describe the prevalence of congenital malformations (CM) at birth in conceptuses (stillbirths and live births) of women hospitalized in institutions located in the city of São Paulo, Brazil. Methods: Descriptive, cross-sectional study carried out at 4 hospitals in the city of São Paulo during 3 months in the 2 and semester of 2011. Data were collected by means of interviews with the women and examinations of hospital records. The CM were studied according to variables of epidemiological and socio-demographic interest. The deaths were analyzed according to underlying and associated causes. Results: The results showed the occurrence of 9.1% of CM registered among stillbirths and 4.3% among live births. Among the latter – 238 newborns – 284 CM were registered, totaling 1.2 CM per live birth with CM registered. Among the 238 newborns that had a CM register, there were 10 deaths by CM (4.2%). This value differs from the one verified among the live births without CM register that died (19 out of 5,341 or 0.4%). Aiming to identify possible  occurrences of death after hospital discharge, a linkage was performed between the official mortality database of the city of São Paulo and the study’s database. The occurrence of 18 deaths was found in this way, 4 of which were caused by CM. Thus, the total of deaths in the 1 st year of life was 47, and 14 of them had CM as the underlying cause, which leads to a proportional infant mortality by CM equal to 29.8% and an infant mortality coefficient by CM of 2.5%o live births. The data show a high undercount of CM in the registers of the official information systems (regarding SINASC, the prevalence of CM in the study was three times the prevalence for the city of São Paulo and 5.4 times the prevalence for Brazil). Conclusion: It is necessary to implement measures to improve the register of CM in the information systems, such as: raising doctors’ awareness concerning the importance of diagnosing CM and registering it in the newborn’s hospital records, creating a specific space to register the CM in the newborn’s hospital records, and qualifying and monitoring the personnel in charge of filling in the Certificate of Live Birth and transcribing it to the information systems

Duration of larval and pupal development stages of Aedes albopictus in natural and artificial containers

Aedes albopictus were reared in different containers: a tree hole, a bamboo stump and an auto tire. The total times from egg hatching to adult emergence were of 19.6,27.3 and 37.5 days, respectively, according to the container. The first, second and third-instar larvae presented growth periods with highly similar durations. The fourth-instar larvae was longer than the others stages. The pupation time was longer than the fourth-instar larvae growth period. The temperature of the breeding sites studied, which was of 18&deg; C to 22&deg; C on average, was also taken into consideration. The mortality of the immature stages was analysed and compared as between the experimental groups; it was lower in the natural containers than in the discarded tire. The average wing length of adult females emerging from tree hole was significantly larger (p < 0.05) than that of those emerging from the tire.Ae. albopictus foi criado em oco de árvore, internódio de bambu e pneu de carro descartável, sob condições de campo. O resultado obtido a partir de larvas recém-nascidas até alado foi de 19,6,27,3 e 37,5 dias. As larvas dos três primeiros estádios tiveram tempo de crescimento similar, não obstante tratar-se de diferentes micro-habitats estudados. Contudo, larvas de 4º estádio apresentaram tempo de duração mais longo e crescente do oco de árvore para o pneu. A temperatura média dos três micro-habitats variou de 18&deg; Ca 22&deg; C. O resultado da taxa de mortalidade encontrada foi menor para larva e pupa do oco de árvore e maior para o pneu. A medida do comprimento médio de asa das fêmeas emergidas do oco de árvore foi maior em relação àquela do pneu