Recreational demand for fishing in the Yellowstone National Park Area : a travel cost model

Potential policy decisions regarding fly fishing in the Yellowstone National Park Area could severely impact the enjoyment possibilities of many of its users. In order to determine the magnitude of the impact, this paper applies a form of the basic travel cost model developed by Bell and Leeworthy [JEEM. 18,189-205 (1990)] to fishing sites in the Yellowstone National Park Area. Bell and Leeworthy have argued that consumer demand for the time spent at a recreation site is inversely related to on-site cost per day, and may be positively related to travel cost per trip. The paper discusses relevant literature on the method, presents background information on the site, and generates a demand curve for users of the resource. A consumer surplus measurement is then derived from the resulting demand data, which gives an estimate for the value of the resource; the consumer surplus is determined to be roughly $751.88 per day spent at the site. The assumptions of the model are then discussed, and an assessment is made of the potential policy implications

Estimating the burden of heat illness in England during the 2013 summer heatwave using syndromic surveillance.

BACKGROUND: The burden of heat illness on health systems is not well described in the UK. Although the UK generally experiences mild summers, the frequency and intensity of hot weather is likely to increase due to climate change, particularly in Southern England. We investigated the impact of the moderate heatwave in 2013 on primary care and emergency department (ED) visits using syndromic surveillance data in England. METHODS: General practitioner in hours (GPIH), GP out of hours (GPOOH) and ED syndromic surveillance systems were used to monitor the health impact of heat/sun stroke symptoms (heat illness). Data were stratified by age group and compared between heatwave and non-heatwave years. Incidence rate ratios were calculated for GPIH heat illness consultations. RESULTS: GP consultations and ED attendances for heat illness increased during the heatwave period; GPIH consultations increased across all age groups, but the highest rates were in school children and those aged ≥75 years, with the latter persisting beyond the end of the heatwave. Extrapolating to the English population, we estimated that the number of GPIH consultations for heat illness during the whole summer (May to September) 2013 was 1166 (95% CI 1064 to 1268). This was double the rate observed during non-heatwave years. CONCLUSIONS: These findings support the monitoring of heat illness (symptoms of heat/sun stroke) as part of the Heatwave Plan for England, but also suggest that specifically monitoring heat illness in children, especially those of school age, would provide additional early warning of, and situation awareness during heatwaves

Bilateral ureteropelvic disruption following blunt abdominal trauma: Case report

<p>Abstract</p> <p>Background</p> <p>Ureteral injury occurs in less than 1% of blunt abdominal trauma cases, partly because the ureters are relatively well protected in the retroperitoneum. Bilateral ureteral injury is extremely rare, with only 10 previously reported cases. Diagnosis may be delayed if ureteric injury is not suspected, and delay of 36 hours or longer has been observed in more than 50% of patients with ureteric injury following abdominal trauma, leading to increased morbidity.</p> <p>Case presentation</p> <p>A 29-year-old man was involved in a highway motor vehicle collision and was ejected from the front passenger seat even though wearing a seatbelt. He was in a preshock state at the scene of the accident. An intravenous line and left thoracic drain were inserted, and he was transported to our hospital by helicopter. Whole-body, contrast-enhanced computed tomography (CT) scan showed left diaphragmatic disruption, splenic injury, and a grade I injury to the left kidney with a retroperitoneal haematoma. He underwent emergency laparotomy. The left diaphragmatic and splenic injuries were repaired. Although a retroperitoneal haematoma was observed, his renal injury was treated conservatively because the haematoma was not expanding. In the intensive care unit, the patient's haemodynamic state was stable, but there was no urinary output for 9 hours after surgery. Anuresis prompted a review of the abdominal x-ray which had been performed after the contrast-enhanced CT. Leakage of contrast material from the ureteropelvic junctions was detected, and review of the repeat CT scan revealed contrast retention in the perirenal retroperitoneum bilaterally. He underwent cystoscopy and bilateral retrograde pyelography, which showed bilateral complete ureteral disruption, preventing placement of ureteral stents. Diagnostic laparotomy revealed complete disruption of the ureteropelvic junctions bilaterally. Double-J ureteral stents were placed bilaterally and ureteropelvic anastomoses were performed. The patient's postoperative progress was satisfactory and he was discharged on the 23^rdday.</p> <p>Conclusion</p> <p>Diagnosis of ureteral injury was delayed, although delayed phase contrast-enhanced CT and abdominal x-rays performed after CT revealed the diagnosis early. Prompt detection and early repair prevented permanent renal damage and the necessity for nephrectomy.</p

Host skin immunity to arthropod vector bites: from mice to humans

Infections caused by vector-borne pathogens impose a significant burden of morbidity and mortality in a global scale. In their quest for blood, hematophagous arthropods penetrate the host skin and may transmit pathogens by the bite. These pathogens are deposited along with saliva and a complex mixture of vector derived factors. Hematophagous arthopod vectors have evolved a complex array of adaptations to modulate the host immune response at the bite site with the primary goal to improve blood feeding, which have been exploited throughout evolution by these pathogens to enhance infection establishment in the host. While this paradigm has been firmly established in mouse models, comparable data from human studies are scarce. Here we review how the host skin immune response to vector bites in animal models is hijacked by microbes to promote their pathogenesis. We mainly explored four distinct vector-pathogen pairs of global health importance: sand flies and Leishmania parasites, Ixodes scapularis ticks and Borrelia burgdorferi, Aedes aegypti mosquitoes and arboviruses, and Anopheles gambiae mosquitos and Plasmodium parasites. Finally, we outline how critical it is for the field of vector biology to shift from rodent models to clinical studies focused on the interface of vector-pathogen-host immune system to push further the frontiers of knowledge of the field

Healthcare-associated Viral Gastroenteritis among Children in a Large Pediatric Hospital, United Kingdom

Enteric viruses introduced from the community are major causes of these illnesses

Age estimation during the blow fly intra-puparial period: a qualitative and quantitative approach using micro-computed tomography

© The Author(s) 2017. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The attached file is the published version of the article

Hedonic Quality or Reward? A Study of Basic Pleasure in Homeostasis and Decision Making of a Motivated Autonomous Robot

© The Author (s) 2016. Published by SAGE. This is an Open Access article distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).We present a robot architecture and experiments to investigate some of the roles that pleasure plays in the decision making (action selection) process of an autonomous robot that must survive in its environment. We have conducted three sets of experiments to assess the effect of different types of pleasure---related versus unrelated to the satisfaction of physiological needs---under different environmental circumstances. Our results indicate that pleasure, including pleasure unrelated to need satisfaction, has value for homeostatic management in terms of improved viability and increased flexibility in adaptive behavior.Peer reviewedFinal Published versio

Engaging with Health Markets in Low and Middle-Income Countries

Many low and middle-income countries have pluralistic health systems with a variety of providers of health-related goods and services in terms of their level of training, their ownership (public or private) and their relationship with the regulatory system. The development of institutional arrangements to influence their performance has lagged behind the spread of these markets. This paper presents a framework for analysing a pluralistic health system. The relationships between private providers of health services and government, or other organisations that represent the public interest, strongly influence their performance in meeting the needs of the poor. Their impact on the pattern of service delivery depends on how the relationships are managed and the degree to which they respond to the interests of the population. Many governments of low and middle-income countries are under pressure to increase access to safe, effective and affordable health services. In a context of economic growth, it should be possible to improve access by the poor to health services substantially. Innovations in information technologies and in low cost diagnostics are creating important new opportunities for achieving this. It will be important to mobilise both public and private providers of health-related goods and services. This will involve big changes in the roles and responsibilities of all health sector actors. Governments, businesses and civil society organizations will need to learn how to make pluralist health systems work better through experimentation and systematic learning about what works and why