Distribution and Habitats of Mosquito Larvae in the Kingdom of Tonga

Mosquitoes are a significant pest and human health issue in the Kingdom of Tonga. The occurrence of species and habitats used by mosquito larvae were investigated to determine the potential for control through larval habitat management. Forty-two sites, including 22 villages and 20 farm plantations on the six islands of Tongatapu, Pangaimotu, Vava’u, Pangaimotu (Vava’u group), ‘Utungake and Nuku, were surveyed in April 2006. A total of eight mosquito species were collected: Aedes aegypti (Linnaeus), Ae. horrescens (Edwards), Ae. nocturnus (Theobold), Ae. tongae (Edwards), Culex albinervis (Edwards), Cx. annulirostris (Skuse), Cx. quinquefasciatus (Say) and Cx. sitiens (Wiedemann). Several species were widespread, particularly Ae. aegypti and Ae. nocturnus on the main island of Tongatapu, whereas Ae. aegypti dominated sites on islands of the Vava’u group. Comparative sampling of 17 village and 17 rural sites showed that larval habitat was more abundant in towns than in rural areas. Larvae were found in a wide range of habitats but were particularly abundant in artificial water bodies (e.g. disused concrete water tanks, 44-gallon drums and used car tyres). In rural sites, habitats were generally sparse except in rain-filled branch stems of giant taro plants. Mosquito populations in artificial habitats could be markedly reduced by seeding disused water tanks with aquatic predators already present in Tonga, using mesh-net covers over 44-gallon drums, and drilling holes in used car tyres

Distribution and Habitats of Mosquito Larvae in the Kingdom of Tonga

Mosquitoes are a significant pest and human health issue in the Kingdom of Tonga. The occurrence of species and habitats used by mosquito larvae were investigated to determine the potential for control through larval habitat management. Forty-two sites, including 22 villages and 20 farm plantations on the six islands of Tongatapu, Pangaimotu, Vava’u, Pangaimotu (Vava’u group), ‘Utungake and Nuku, were surveyed in April 2006. A total of eight mosquito species were collected: Aedes aegypti (Linnaeus), Ae. horrescens (Edwards), Ae. nocturnus (Theobold), Ae. tongae (Edwards), Culex albinervis (Edwards), Cx. annulirostris (Skuse), Cx. quinquefasciatus (Say) and Cx. sitiens (Wiedemann). Several species were widespread, particularly Ae. aegypti and Ae. nocturnus on the main island of Tongatapu, whereas Ae. aegypti dominated sites on islands of the Vava’u group. Comparative sampling of 17 village and 17 rural sites showed that larval habitat was more abundant in towns than in rural areas. Larvae were found in a wide range of habitats but were particularly abundant in artificial water bodies (e.g. disused concrete water tanks, 44-gallon drums and used car tyres). In rural sites, habitats were generally sparse except in rain-filled branch stems of giant taro plants. Mosquito populations in artificial habitats could be markedly reduced by seeding disused water tanks with aquatic predators already present in Tonga, using mesh-net covers over 44-gallon drums, and drilling holes in used car tyres

Methylmercury in marine ecosystems : spatial patterns and processes of production, bioaccumulation, and biomagnification

Author Posting. © International Association for Ecology and Health, 2008. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in EcoHealth 5 (2008): 399-408, doi:10.1007/s10393-008-0201-1.The spatial variation of MeHg production, bioaccumulation and biomagnification in marine food webs is poorly characterized but critical to understanding the links between sources and higher trophic levels such as fish that are ultimately vectors of human and wildlife exposure. This paper discusses both large and local scale processes controlling Hg supply, methylation, bioaccumulation and transfer in marine ecosystems. While global estimates of Hg supply suggest important open ocean reservoirs of MeHg, only coastal processes and food webs are known sources of MeHg production, bioaccumulation, and bioadvection. The patterns observed to date suggest that not all sources and biotic receptors are spatially linked and that physical and ecological processes are important in transferring MeHg from source regions to bioaccumulation in marine food webs and from lower to higher trophic levels.Supported by NIH Grant Number P42 ESO7373 from the NIEHS, SERDP funds from the Department of Defense, the ESSRF (Environmental Science Strategic Research Fund) DFO, Canada, Woods Hole Sea Grant, Woods Hole Coastal Ocean Institute, National Science Foundation, and RI-INBRE Grant #P20RR016457 from NCRR, NIH

Birth data accessibility via primary care health records to classify health status in a multi-ethnic population of children: an observational study

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Laboratory evidence of disseminated intravascular coagulation is associated with a fatal outcome in children with cerebral malaria despite an absence of clinically evident thrombosis or bleeding

Background A procoagulant state is implicated in cerebral malaria (CM ) pathogenesis, but whether disseminated intravascular coagulation (DIC ) is present or associated with a fatal outcome is unclear. Objectives To determine the frequency of overt DIC , according to ISTH criteria, in children with fatal and non‐fatal CM . Methods/patients Malawian children were recruited into a prospective cohort study in the following diagnostic groups: retinopathy‐positive CM (n = 140), retinopathy‐negative CM (n = 36), non‐malarial coma (n = 14), uncomplicated malaria (UM ), (n = 91), mild non‐malarial febrile illness (n = 85), and healthy controls (n = 36). Assays in the ISTH DIC criteria were performed, and three fibrin‐related markers, i.e. protein C, antithrombin, and soluble thrombomodulin, were measured. Results and conclusions Data enabling assignment of the presence or absence of ‘overt DIC ’ were available for 98 of 140 children with retinopathy‐positive CM . Overt DIC was present in 19 (19%), and was associated with a fatal outcome (odds ratio [OR] 3.068; 95% confidence interval [CI] 1.085–8.609; P = 0.035]. The levels of the three fibrin‐related markers and soluble thrombomodulin were higher in CM patients than in UM patients (all P < 0.001). The mean fibrin degradation product level was higher in fatal CM patients (71.3 μg mL−1 [95% CI 49.0–93.6]) than in non‐fatal CM patients (48.0 μg mL−1 [95% CI 37.7–58.2]; P = 0.032), but, in multivariate logistic regression, thrombomodulin was the only coagulation‐related marker that was independently associated with a fatal outcome (OR 1.084 for each ng mL−1 increase [95% CI 1.017–1.156]; P = 0.014). Despite these laboratory derangements, no child in the study had clinically evident bleeding or thrombosis. An overt DIC score and high thrombomodulin levels are associated with a fatal outcome in CM , but infrequently indicate a consumptive coagulopathy

On the Extended Emission Around the Anomalous X-ray Pulsar 1E 1547.0-5408

We present an analysis of the extended emission around the anomalous X-ray pulsar 1E 1547.0-5408 using four XMM-Newton observations taken with the source in varying states of outburst as well as in quiescence. We find that the extended emission flux is highly variable and strongly correlated with the flux of the magnetar. Based on this result, as well as on spectral and energetic considerations, we conclude that the extended emission is dominated by a dust-scattering halo and not a pulsar wind nebula (PWN), as has been previously argued. We obtain an upper limit on the 2-10 keV flux of a possible PWN of 4.7e-14 erg/s/cm^2, three times less than the previously claimed value, implying an efficiency for conversion of spin-down energy into nebular luminosity of <9e-4 (assuming a distance of 4 kpc). We do, however, find strong evidence for X-ray emission from the supernova remnant shell surrounding the pulsar, as previously reported.Comment: 16 pages, 3 tables, 4 figures, published in the Astrophysical Journa

Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial

BACKGROUND: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional &quot;waitlist and triage&quot; model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction. METHODS/DESIGN: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12&nbsp;weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial. DISCUSSION: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.<br /

"Am iz kwiin" (I'm his queen): Combining interpretative phenomenological analysis with a feminist approach to work with gems in a resource-constrained setting

This article focuses on working with gems using a feminist approach to interpretative phenomenological analysis (IPA) in a resource-constrained setting. The research explores the experiences of maternal disclosure of HIV to children of HIV positive mothers in Kingston, Jamaica. A feminist approach helps recognise power imbalances within research relationships and the women’s lived experiences. We present three “gems” which illuminate women’s lived experiences and explore how popularised representations of women’s sexuality and mothering influence disclosure discourses. We use emotion work as a conceptual resource to structure the women’s narratives and challenge existing policy discourses, which arguably represent disclosure within a binary, rationalist, decision-making framework. This article adds to global literature on maternal HIV disclosure and problematises policy discourses by bringing into relief the emotion work women engage in when deciding if and how to communicate their HIV status to their children. It adds to the body of research using IPA, particularly in resource-constrained settings where IPA has thus far had little application

Mutual Information for the Detection of Crush

Fatal crush conditions occur in crowds with tragic frequency. Event organizers and architects are often criticised for failing to consider the causes and implications of crush, but the reality is that both the prediction and prevention of such conditions offer a significant technical challenge. Full treatment of physical force within crowd simulations is precise but often computationally expensive; the more common method of human interpretation of results is computationally “cheap” but subjective and time-consuming. This paper describes an alternative method for the analysis of crowd behaviour, which uses information theory to measure crowd disorder. We show how this technique may be easily incorporated into an existing simulation framework, and validate it against an historical event. Our results show that this method offers an effective and efficient route towards automatic detection of the onset of crush