Stakeholders' perceptions of rehabilitation services for individuals living with disability:A survey study

Background: The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes.   Methods: We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale.   Results: Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively).   Conclusion: The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their acceptability. The majority of stakeholders found 'Task shifting' as neither feasible nor acceptable

Radical political unionism reassessed

Defections from European social-democratic parties and a resurgence of union militancy have prompted some to diagnose a new left-wing trade unionism across Europe. This comment on the article by Connolly and Darlington scrutinizes trends in France and Germany but primarily analyses recent developments in Britain. While there are some instances of disaffiliation from the Labour Party, support for electoral alternatives, growth in political militancy and emphasis on new forms of internationalism, these have been limited. There is insufficient evidence to suggest that we are witnessing the making of a new radical collectivism

Evaluation of the Benefits to Sustainable Management of Seasonal Closure of the Greencastle Codling (Gadus morhua) Fishery

The project examined whether the seasonal closure of the traditional cod fishing grounds off Greencastle, Co. Donegal, could be an effective alternative management measure. The project was instigated by the local fishing industry and operated in cooperation between industry, the Marine Institute and Bord Iascaigh Mhara. The main objectives of the project were to demonstrate the change in yield likely to result from seasonal closure, and, to determine the pattern of movement of cod from the Greencastle fishery. Each winter from 2003 to 2005 the fishery was closed by Statutory Instrument. This was achieved with the voluntary commitment of the local industry. During this period over 13,000 cod were tagged and released by Marine Institute and BIM staff working aboard chartered fishing vessels. The closure itself provided a significant conservation benefit. During 2000-2002 50% of the Irish catch weight of cod in Division VIa (> 60% by number) was taken in the winter. The closure will therefore have markedly reduced the fishing mortality on cod that would otherwise have occurred from 2003 to 2005. As the Greencastle codling fishery is a mixed whitefish fishery, any benefits flowing from the closure are likely to have extended to other whitefish stocks. Growth was extremely variable but averaged around 17 cm per annum for cod at liberty for extended periods. During the winter tagging surveys the repeated recapture of recently tagged cod on the grounds indicated the retention of cod on the grounds during winter. Tagged cod at liberty for extended periods were subsequently recaptured on, or near the Cape grounds. This strong fidelity towards the Cape grounds during winter coupled with high growth rates may mean that a short winter fishing season, with a delayed opening, may yield a similar total weight of codling than the traditional fishery but with the catch of a reduced number of cod. Such schemes may reduce current fishing mortality rates. However, the stock status of Division VIa cod is so poor that a complete closure of the fishery is warranted. It is recommended that continuation of the project be considered as a mechanism for maintaining a closure of most of the Irish fishery, whilst simultaneously improving the quality of data available for stock assessment.Funder: Marine Institut

Improvement in fingerprint detection using Tb(III)-dipicolinic acid complex doped nanobeads and time resolved imaging.

This paper deals with the synthesis and application of lanthanide complex doped nanobeads used as a luminescent fingerprint powder. Due to their special optical properties, namely a long emission lifetime, sharp emission profiles and large Stokes shifts, luminescent lanthanide complexes are useful for discriminating against signals from background emissions. This is a big advantage because latent fingerprints placed on multicoloured fluorescent surfaces are difficult to develop with conventional powders. The complex of 2,6-dipicolinic acid (DPA) and terbium ([Tb(DPA)3]3-) is used for this purpose. Using the Stöber process, this complex is incorporated into a silica matrix forming nanosized beads (230-630nm). It is shown that the [Tb(DPA)3]3- is successfully incorporated into the beads and that these beads exhibit the wanted optical properties of the complex. A phenyl functionalisation is applied to increase the lipophilicity of the beads and finally the beads are used to develop latent fingerprints. A device for time resolved imaging was built to improve the contrast between developed fingerprint and different background signals, whilst still detecting the long lasting luminescence of the complex. The developed fingerprint powder is therefore promising to develop fingerprints on multicoloured fluorescent surfaces

Measuring functional ability in healthy ageing: a nationwide cross-sectional survey in the Philippine older population

OBJECTIVES: To analyse the empirical support of the functional ability concept in the healthy ageing framework developed by the WHO in a sample of the Philippine older population. According to this framework, environmental factors may enhance or hinder functional ability, which is the person's ability to do what they value, broadly represented by subjective well-being. Moreover, this network of relationships may be moderated by personal characteristics such as gender. DESIGN: Cross-sectional observational study. SETTING: Philippines, general population. PARTICIPANTS: Respondents of the 2016 National Disability Prevalence Survey/Model Functioning Survey aged 50+ (N=2825). PRIMARY AND SECONDARY OUTCOME MEASURES: Latent (unobserved) measures of functional ability, environmental factors (physical environmental factors and social network and support) and subjective well-being (positive affect, negative affect and evaluative well-being) were obtained from different items from the survey questionnaire using a SEM framework. RESULTS: We found that the relationship between environmental factors and the three components of subjective well-being considered in this study was partially explained by differences in functional ability. The portion of those effects accounted for by functional ability was comparatively larger for the physical than for the social environmental factors. We found no evidences of gender differences in this network of relationships. CONCLUSIONS: These findings suggest the relevance of functional ability at explaining the relationship between environmental factors and subjective well-being in older adults. Future studies may replicate these findings longitudinally and including other relevant measures as the person's objective level of intrinsic capacity

Een dubbele dijk met driedubbele doelen

De huidige zeedijk in de Eemsdelta voldoet niet meer aan de veiligheidsnormen. Omdat de dijk in een aardbevingsgevoelig gebied ligt is dijkversterking urgent. Daarnaast heeft Noordoost-Groningen behoefte aan nieuwe economische impulsen, en is voor de natuur in het Eems-estuarium kwaliteitsverbetering dringend gewenst. Dit was aanleiding voor de provincie Groningen om te onderzoeken of een innovatieve, multifunctionele dubbele dijk haalbaar is. Daarmee kunnen drie doelen worden bereikt: meer veiligheid, nieuwe economische dragers en meer biodiversiteit

Testing for sexually transmitted infections in general practice: cross-sectional study

Background: Primary care is an important provider of sexual health care in England. We sought to explore the extent of testing for chlamydia and HIV in general practice and its relation to associated measures of sexual health in two contrasting geographical settings.Methods: We analysed chlamydia and HIV testing data from 64 general practices and one genitourinary medicine (GUM) clinic in Brent (from mid-2003 to mid-2006) and 143 general practices and two GUM clinics in Avon (2004). We examined associations between practice testing status, practice characteristics and hypothesised markers of population need (area level teenage conception rates and Index of Multiple Deprivation, IMD scores).Results: No HIV or chlamydia testing was done in 19% (12/64) of general practices in Brent, compared to 2.1% (3/143) in Avon. In Brent, the mean age of general practitioners (GPs) in Brent practices that tested for chlamydia or HIV was lower than in those that had not conducted testing. Practices where no HIV testing was done had slightly higher local teenage conception rates (median 23.5 vs. 17.4/1000 women aged 15-44, p = 0.07) and served more deprived areas (median IMD score 27.1 vs. 21.8, p = 0.05). Mean yearly chlamydia and HIV testing rates, in practices that did test were 33.2 and 0.6 (per 1000 patients aged 15-44 years) in Brent, and 34.1 and 10.3 in Avon, respectively. In Brent practices only 20% of chlamydia tests were conducted in patients aged under 25 years, compared with 39% in Avon.Conclusions: There are substantial geographical differences in the intensity of chlamydia and HIV testing in general practice. Interventions to facilitate sexually transmitted infection and HIV testing in general practice are needed to improve access to effective sexual health care. The use of routinely-collected laboratory, practice-level and demographic data for monitoring sexual health service provision and informing service planning should be more widely evaluated

Genomic insights into anthropozoonotic tuberculosis in captive sun bears (Helarctos malayanus) and an Asiatic black bear (Ursus thibetanus) in Cambodia

Contact between humans and wildlife presents a risk for both zoonotic and anthropozoonotic disease transmission. In this study we report the detection of human strains of Mycobacterium tuberculosis in sun bears and an Asiatic black bear in a wildlife rescue centre in Cambodia, confirming for the first time the susceptibility of these bear species to tuberculosis when in close contact with humans. After genotyping revealed two different strains of M. tuberculosis from cases occurring between 2009 and 2019, 100 isolates from 30 sun bear cases, a single Asiatic black bear case, and a human case were subjected to whole genome sequencing. We combined single nucleotide polymorphism analysis and exploration of mixed base calls with epidemiological data to indicate the evolution of each outbreak. Our results confirmed two concurrent yet separate tuberculosis outbreaks and established a likely transmission route in one outbreak where the human case acted as an intermediatory between bear cases. In both outbreaks, we observed high rates of transmission and progression to active disease, suggesting that sun bears are highly susceptible to tuberculosis if exposed under these conditions. Overall, our findings highlight the risk of bi-directional transmission of tuberculosis between humans and captive bears in high human tuberculosis burden regions, with implied considerations for veterinary and public health. We also demonstrate the use of standard genomic approaches to better understand disease outbreaks in captive wildlife settings and to inform control and prevention measures

The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review

PMCID: PMC3408383The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1741-7015/10/75. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited