Die verband tussen trekangs, diensjare en posttraumatiese stresversteuring by polisiebeamptes

In the course of duty, officers of the South African Police Services face highly stressful, life-threatening situations. This article discusses a model in which trait anxiety and years of service were specified as potential predictors of post-traumatic stress disorder. Structural equation modelling produced a satisfactory fit between the model and the observed data. In combination trait anxiety and years of service account for about 30% of the variance in symptoms of post-traumatic stress disorder. The article also makes recommendations as to how these results may usefully be applied in order to prevent the development of post-traumatic stress disorder among police officers

A Risk Assessment of Aflatoxin M1 Exposure in Low and Mid-Income Dairy Consumers in Kenya

Aflatoxin M1 (AFM1), a human carcinogen, is found in milk products and may have potentially severe health impacts on milk consumers. We assessed the risk of cancer and stunting as a result of AFM1 consumption in Nairobi, Kenya, using worst case assumptions of toxicity and data from previous studies. Almost all (99.5%) milk was contaminated with AFM1. Cancer risk caused by AFM1 was lower among consumers purchasing from formal markets (0.003 cases per 100,000) than for low-income consumers (0.006 cases per 100,000) purchasing from informal markets. Overall cancer risk (0.004 cases per 100,000) from AFM1 alone was low. Stunting is multifactorial, but assuming only AFM1 consumption was the determinant, consumption of milk contaminated with AFM1 levels found in this study could contribute to 2.1% of children below three years in middle-income families, and 2.4% in low-income families, being stunted. Overall, 2.7% of children could hypothetically be stunted due to AFM1 exposure from milk. Based on our results AFM1 levels found in milk could contribute to an average of −0.340 height for age z-score reduction in growth. The exposure to AFM1 from milk is 46 ng/day on average, but children bear higher exposure of 3.5 ng/kg bodyweight (bw)/day compared to adults, at 0.8 ng/kg bw/day. Our paper shows that concern over aflatoxins in milk in Nairobi is disproportionate if only risk of cancer is considered, but that the effect on stunting children might be much more significant from a public health perspective; however, there is still insufficient data on the health effects of AFM1.Peer reviewe

Die verband tussen trekangs, diensjare en posttraumatiese stresversteuring by polisiebeamptes

In the course of duty, officers of the South African Police Services face highly stressful, life-threatening situations. This article discusses a model in which trait anxiety and years of service were specified as potential predictors of post-traumatic stress disorder. Structural equation modelling produced a satisfactory fit between the model and the observed data. In combination trait anxiety and years of service account for about 30% of the variance in symptoms of post-traumatic stress disorder. The article also makes recommendations as to how these results may usefully be applied in order to prevent the development of post-traumatic stress disorder among police officers

The Importance of Urban Eco-gardens for Biodiversity and Human Sustainability: A Case Study from Palestine

The situation in Palestine is of concern where global threats of climate change, overexploitation, habitat destruction, invasive species, and pollution are compounded by occupation and conflict. Thus, almost 1/3rd of vascular plant species are rare and over 50 are listed as endangered or rare based on their abundance and presence in grids studied earlier. Here, we describe the development of a conservation botanic garden that works via research, education, and direct in situ and ex situ conservation of plant species. The garden now boasts 381 species of vascular plants (63 are rare). The team scientifically and selectively introduced some rare and endemic species, developed educational modules, and engaged the community in all aspects of planning and growth of this garden. It has acted as a model for threatened and protected areas in the state of Palestine, as well as becoming a national oasis for both wildlife and humans. The lessons learned from this experience include: 1) principles of minimal intervention in eco-friendly ways producing zones of permaculture and gardening towards conservation (ex situ and in situ conservation), while allowing botanic garden functionality, 2) involvement of staff, volunteers, experts, and community in education and conservation efforts, 3) value of research in plants and animals for integrated ecosystem management. The outcome of this work is a maximally utilitarian garden for areas like education, direct conservation, research, and human satisfaction whilst ensuring long-term sustainability in a nascent state in the midst of a difficult political situation

Using ecosystem models to inform ecosystem-based fisheries management in Europe: a review of the policy landscape and related stakeholder needs

The need to implement an ecosystem-based fisheries management (EBFM) is enshrined in numerous regulations and strategies, at both global and European level. In practice, it is challenging to implement EBFM because it requires a complex evaluation of interlinked management effects and environmental and climate forcing on multi-species interactions, habitat status and human activities. Ecosystem models are one of the most critical research tools to inform EBFM, because they can integrate a wide variety of data, examine multiple and complex ecosystem interactions, and can make forecasts based on specific management scenarios. However, despite clear progress in marine ecosystem modelling, many models do not address policy goals and targets, which hinders uptake in policy. In this paper, we review the global and European policies and implementing bodies which directly or indirectly have a repercussion on the implementation of EBFM. Moreover, we highlight specific stakeholder needs related to the implementation of EBFM in European waters, which ecosystem models could help address. We review the policy commitments that drive these needs and the concerns raised by stakeholders during a survey and dedicated workshop. Key topics of concern were effects of climate change; bycatch; protected areas/fisheries restricted areas; and reducing the impacts of trawling. Stakeholders also provided specific questions related to these topics which ecosystem models could help address. Scenario and data results visualizations, as well as specific barriers in using the results of ecosystem models for decision-making are also discussed. A close involvement of stakeholders in scenario development and in designing graphical outputs is important, and can help overcome some of the main barriers that can hinder uptake of models and scenarios, including a lack of understanding of the benefits and limits of ecosystem models; insufficient involvement and interaction with stakeholders; and inadequate characterization of uncertainties.publishedVersio

Antimicrobial use in a peri-urban smallholder poultry system, Kenya

Objective(s): Analyze distribution and current usage of veterinary drugs in peri-urban smallholder poultry systems, Kenya Materials and methods: Machakos and Kajiado counties were purposively selected for the study. A baseline survey involving poultry farmers was conducted. Additional data were collected through key informant interviews (KII). The questionnaire data were electronically captured using open data kit, downloaded as a MS Excel® file, and cleaned. The data were analyzed using both descriptive and thematic approaches. Results: A total of 100 farmers were interviewed. Majority (58%) were >50 years old and kept chicken (100%), ducks (17%) and turkeys (16%). Methods for drug package disposal included burning (65%), burying (10%), and in pit latrines (9%). Sharing of same drugs across livestock species was reported (11 of the 66 farmers who kept other livestock). A small percentage (9%) mentioned using drugs intended for humans in animal treatment. Antibiotics constituted 47% of the total drug records used by farmers (n=347); 24% were used within the previous one month (24%) and had been administered by farmers themselves (90%). Challenges associated with the distribution, access and disposal of veterinary products were highlighted by KII respondents. Conclusion: on-prudent use of antimicrobials is a driver for development of antimicrobial resistance (AMR) which has serious public health implications. This project is developing an ICT framework to improve AMU monitoring and address the current information gap on AMR

Genetic Evaluation of A Nation-Wide Dutch Pediatric DCM Cohort:The Use of Genetic Testing in Risk Stratification

BACKGROUND: This study aimed to describe the current practice and results of genetic evaluation in Dutch children with dilated cardiomyopathy and to evaluate genotype-phenotype correlations that may guide prognosis. METHODS: We performed a multicenter observational study in children diagnosed with dilated cardiomyopathy, from 2010 to 2017. RESULTS: One hundred forty-four children were included. Initial diagnostic categories were idiopathic dilated cardiomyopathy in 67 children (47%), myocarditis in 23 (16%), neuromuscular in 7 (5%), familial in 18 (13%), inborn error of metabolism in 4 (3%), malformation syndrome in 2 (1%), and "other" in 23 (16%). Median follow-up time was 2.1 years [IQR 1.0-4.3]. Hundred-seven patients (74%) underwent genetic testing. We found a likely pathogenic or pathogenic variant in 38 children (36%), most often in MYH7 (n = 8). In 1 patient initially diagnosed with myocarditis, a pathogenic LMNA variant was found. During the study, 39 patients (27%) reached study endpoint (SE: all-cause death or heart transplantation). Patients with a likely pathogenic or pathogenic variant were more likely to reach SE compared with those without (hazard ratio 2.8; 95% CI 1.3-5.8, P = 0.007), while transplant-free survival was significantly lower (P = 0.006). Clinical characteristics at diagnosis did not differ between the 2 groups. CONCLUSIONS: Genetic testing is a valuable tool for predicting prognosis in children with dilated cardiomyopathy, with carriers of a likely pathogenic or pathogenic variant having a worse prognosis overall. Genetic testing should be incorporated in clinical work-up of all children with dilated cardiomyopathy regardless of presumed disease pathogenesis

Genomic Characterization of Cholangiocarcinoma in Primary Sclerosing Cholangitis Reveals Therapeutic Opportunities

Background and Aims Lifetime risk of biliary tract cancer (BTC) in primary sclerosing cholangitis (PSC) may exceed 20%, and BTC is currently the leading cause of death in patients with PSC. To open new avenues for management, we aimed to delineate clinically relevant genomic and pathological features of a large panel of PSC-associated BTC (PSC-BTC). Approach and Results We analyzed formalin-fixed, paraffin-embedded tumor tissue from 186 patients with PSC-BTC from 11 centers in eight countries with all anatomical locations included. We performed tumor DNA sequencing at 42 clinically relevant genetic loci to detect mutations, translocations, and copy number variations, along with histomorphological and immunohistochemical characterization. Regardless of the anatomical localization, PSC-BTC exhibited a uniform molecular and histological characteristic similar to extrahepatic cholangiocarcinoma. We detected a high frequency of genomic alterations typical of extrahepatic cholangiocarcinoma, such asTP53(35.5%),KRAS(28.0%),CDKN2A(14.5%), andSMAD4(11.3%), as well as potentially druggable mutations (e.g.,HER2/ERBB2). We found a high frequency of nontypical/nonductal histomorphological subtypes (55.2%) and of the usually rare BTC precursor lesion, intraductal papillary neoplasia (18.3%). Conclusions Genomic alterations in PSC-BTC include a significant number of putative actionable therapeutic targets. Notably, PSC-BTC shows a distinct extrahepatic morpho-molecular phenotype, independent of the anatomical location of the tumor. These findings advance our understanding of PSC-associated cholangiocarcinogenesis and provide strong incentives for clinical trials to test genome-based personalized treatment strategies in PSC-BTC.Peer reviewe

Comprehensive molecular characterization of gastric adenocarcinoma

Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies