Ebola and War in the Democratic Republic of Congo: Avoiding Failure and Thinking Ahead

The Ebola epidemic in the Democratic Republic of Congo (DRC) is exceptionally dangerous, occurring within active armed conflict and geopolitical volatility, including a million displaced persons. With 421 cases, 240 deaths, and the numbers increasing, this Ebola outbreak is the second deadliest in history. Recent spread to Butembo, home to 1.2 million people, raised concerns. The DRC, World Health Organization (WHO), and partners are leading a vigorous international response, yet despite deploying an experimental vaccine, cases doubled in October 2018 and many cases had unknown origin. Uncontrolled Ebola outbreaks can expand quickly, as occurred in West Africa in 2014. Averting that outcome in the DRC requires rapid action including a strengthened public health response, security, and community outreach. If violence escalates, it could compromise a fragile response. Yet resources are insufficient. The United States and other countries are not permitting personnel deployment to the epicenter, including from the Centers for Disease Control and Prevention (CDC) and US Agency for International Development (USAID). In this Viewpoint, we review recommendations of experts convened by Georgetown University and listed at the end of this article. The United States and international community should launch high-level political mobilization, with diplomatic, human, and economic resources. It is critical to recognize that future health crises will occur in fragile, insecure settings. To prepare, the international community needs long-term planning and enhanced capacities to improve the safety and effectiveness of epidemic response operations

Digital Literacy: Why It Matters

In the past two decades the internet, email, apps, mobile devices and all associated hardware and software have become firmly embedded in everyday life, to the extent that it often feels that we have had no control over this phenomenon. What are the implications for education? Primary and secondary students today have grown up with the always-connected life which the internet has enabled. However, the credence given to the idea that this makes them fully comfortable and aware as digital natives is misguided. The social implications of the internet society – surveillance and the decline of privacy, cyberbullying and so on – are only now becoming evident. Are our students developing skills for living, learning and working in a digital society? For that matter, do those of us who teach and offer guidance ourselves possess those capabilities? How can we tell? This chapter attempts to define digital literacy, outlines some of the ways in which guidance counsellors can help students develop their digital literacy, and looks how guidance counsellors can develop their own digital literacy skills

Stillorgan QBC Dwell Time Analysis

on the Stillorgan Quality Bus Corridor (QBC), a key arterial bus corridor accessing Dublin city centre from its suburbs. The focus of the study was to understand the pattern of dwell-time on the corridor and to identify potential areas, if any, where service levels may be enhanced. The study should provide a beneficial and detailed observation of in-journey bus operations. This in turn can help to understand the impact of ticketing, boarding/alighting and other aspects of journey dwell within a high-level of service bus corridor. The Stillorgan QBC, between Foxrock Church and Leeson Street Bridge, comprises of 28 bus stops, 32 signalised junctions and measures approximately 9km. There are 60 locations, exclusive of running-time delays, where there is the potential for dwell to occur. 21 inbound journey time surveys were carried out in the morning commuter peak period over 7 days between the hours of 07:00 and 10:00, with 3 surveys carried out every day, one in each hour. Approximately 1,200 passenger boardings and 900 alightings were recorded. Individual fare transaction times were also surveyed. Several key findings emerged from the study. Dwell at junctions accounts for 13% of total journey time, with boarding and alighting accounting for 23%. 59% of passengers surveyed alight at four individual stops, and 24% of those surveyed board at two individual stops. Journey times are very variable, with a difference of 23 minutes between shortest and longest journeys (a variance of 110%). This has improved considerably since the last QBC Monitoring Report in 2010 when variances of 259% were recorded. Pre-paid tickets are the most popular and fastest method of payment with 55% of those surveyed using this method. Pre-paid ticket users take on average 7 seconds to board. There is no time-saving for LEAP Card (e-purse) users, who take on average 10 seconds to board (being the same for cash payers). The findings present evidence to support the implementation of off-board ticket purchase and/or the removal of both cash and e-purse ticket transactions from services. Service planning improvements, such as the consolidation of stops, multi-door entry/exit systems and measures to improve performance at junctions, are also suggested

A study of interface adhesion between polyamide 6 (PA6) and nitrile rubber (NBR)

This is the peer reviewed version of the following article: Wang Y., Ghita O., Kavanagh D., and Chandler D. (2014), A study of interface adhesion between polyamide 6 (PA6) and nitrile rubber (NBR), Surf. Interface Anal., 10-11, pages 1000–1004, which has been published in final form at 10.1002/sia.5488. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving: http://olabout.wiley.com/WileyCDA/Section/id-820227.html#termsThe mechanism of interface bonding of a selected nitrile rubber compound vulcanized on polyamide 6 was studied using transmission electron microscopy. The two types of interfaces identified were formed through mechanical clamping and enhanced by hydrogen bonding between polyamide 6 and silane coupling agent in nitrile rubber compoun

Tuberculosis, human rights, and law reform: Addressing the lack of progress in the global tuberculosis response

In 2018, the United Nations General Assembly convened the first-ever high-level meeting (HLM) on tuberculosis (TB). Since that time news on the world’s most lethal infectious disease is not good—the 2019 WHO TB report shows 1.2 million people died from TB, a number that has fallen just 11% since 2015, less than one-third of the way towards the End TB Strategy milestone of a 35% reduction (to about 850 million deaths) by 2020. The same number of people, 10.0 million, are estimated to have fallen ill with TB in 2018 as in 2017. The stubborn persistence of TB is attributable to glaring gaps in case detection and treatment. While case detection has increased in recent years, there is still a significant gap between the 7 million new cases reported and the 10 million incident cases estimated in the most recent WHO data—and treatment success continues to hover at only 85%. There has long been a call for a shift toward a “human rights-based approach” in TB—building policies and programs explicitly on the norms and values set out in international human rights law, treating people with TB as rights holders in their interaction with the state and the health system, and working to overcome stigma and discrimination. Yet laws in high TB-burden countries (HBCs) have not been reformed to include basic rights protections. This helps explain the lack of progress, as individuals who fear discrimination and coercion may avoid diagnosis and treatment. Thus, TB stands in stark contrast to HIV/AIDS, for which the international community has moved far more decisively to recognize and protect key rights, even as more progress is needed. At the UN, heads of state committed to removing discriminatory laws and policies against people with TB, protecting and promoting their human rights and dignity, as a key part of a strategy to improve the TB response and end the epidemic. Here, we analyze key areas of law with particular importance for TB, focusing on five aspects of compulsory public health powers in law and on laws related to migration. We identify significant gaps between core human rights norms and existing legal environments

Peritoneal Dialysis Catheters

In peritoneal dialysis, a well-functioning catheter is of great importance because a dysfunctional catheter may be associated with exit-site infection, peritonitis, reduced efficiency of dialysis, and overall quality of treatment, representing one of the main barriers to optimal use of peritoneal dialysis. This chapter reviews the literature on indications and contraindications for peritoneal dialysis, peritoneal dialysis catheter design and materials, the techniques of insertion, complications, and method of removal of dialysis catheters

Laparoscopic Repair of Postoperative Perineal Hernia

Perineal hernias are infrequent complications following abdominoperineal operations. Various approaches have been described for repair of perineal hernias including open transabdominal, transperineal or combined abdominoperineal repairs. The use of laparoscopic transabdominal repair of perineal hernias is not well-described. We present a case report demonstrating the benefits of laparoscopic repair of perineal hernia following previous laparoscopic abdominoperineal resection (APR) using a nonabsorbable mesh to repair the defect. We have demonstrated that the use of laparoscopy with repair of the pelvic floor defect using a non absorbable synthetic mesh offers an excellent alternative with many potential advantages over open transabdominal and transperineal repairs

Dynamic Magnetic Resonance Imaging Demonstrates the Integrity of Perineal Reconstruction following Cylindrical Abdominoperineal Excision with Reconstruction of the Pelvic Floor Using Porcine Collagen

A 72-year-old female presented with a six-month history of increased frequency of defecation, rectal bleeding, and severe rectal pain. Digital rectal examination and endoscopy revealed a low rectal lesion lying anteriorly. This was confirmed histologically as adenocarcinoma. Radiological staging was consistent with a T3N2 rectal tumour. Following long-course chemoradiotherapy repeat staging did not identify any metastatic disease. She underwent a laparoscopic cylindrical abdominoperineal excision with en bloc resection of the coccyx and posterior wall of the vagina with a negative circumferential resection margin. The perineal defect was reconstructed with Permacol (biological implant, Covidien) mesh. She had no clinical evidence of a perineal hernia at serial followup. Dynamic MRI images of the pelvic floor obtained during valsalva at 10 months revealed an intact pelvic floor. A control case that had undergone a conventional abdominoperineal excision with primary perineal closure without clinical evidence of herniation was also imaged. This confirmed subclinical perineal herniation with significant downward migration of the bowel and bladder below the pubococcygeal line. We eagerly await further evidence supporting a role for dynamic MR imaging in assessing the integrity of a reconstructed pelvic floor following cylindrical abdominoperineal excision

Home range and habitat use of the endangered grey partridge (perdix perdix) in the Irish midlands.

O’GORMAN, E.C., KAVANAGH, B. and ROCHFORD,J.: HOME RANGE AND HABITAT USE BY THE ENDANGERED GREY PARTRIDGE (Perdix perdix) IN THE IRISH MIDLANDS: The last potentially viable population of native Irish Grey Partridge (Perdix perdix) is located over a 25 km2 area at Boora bog, Co. Offaly, in the Irish midlands. The habitat is a mosaic of cutaway bogland, coniferous forestry, newly created farmland and wetlands. Since 1996 a combination of predation control and the provision of habitat strips has been the focus of conservation efforts in Boora in an attempt to increase partridge numbers in the short-term. The aim of this study is to provide baseline information on partridge movements and habitat use in the conservation site. The result of two years fieldwork is presented. An area of 18 km2 was mapped during the course of fielwork. Nine male birds were radio-tracked. The biological time periods (B.T.P.) calculated for breeding pairs were Exploration, Prelay, Lay, Incubation, Brood rearing, Primary and Secondqary covey movements. The home range varied in size and location from one B.T.P. to the next. This was linked to habitat availability. Breeding attempts occurred in young forestry plantations and newly created habitat strips within the cutaway bog area. The coveys left the cutaway bog area in late summer to feed on nerby pasture. A second movement in late Autumn was made to utilise winter stubbles on adjacent farmland. Birds returned to breeding sites in the cutaway bog area the following spring. The practical applications of the findings to the conservation effort are discussed