Going Nordic in European Administrative Networks?

The integration and policymaking of the European Union (EU) are claimed to challenge Nordic cooperation as a separate ‘common order.’ Increasing interdependencies in the EU have forced all EU member states to collaborate and share sovereignty in an increasing number of policy areas. This article studies the coexistence of Nordic cooperation and European integration by taking a network approach. It analyses the extent to which Nordic members of European Administrative Networks ‘go Nordic’ to solve problems or exchange advice, information and best practices. Based on unique survey data on interactions related to the implementation of EU policies in Social Policy, Health and the Internal Market by national governmental organisations across the EU and the European Economic Area (EEA), we use social network analysis to test for distinguishable patterns of Nordic cooperation. We find evidence to suggest that Nordic cooperation in the EU and EEA is best characterised by differentiated integration. The Nordic states tend to form a separate community for problem-solving and exchanging best practices, advice and information in Health and Social policy networks, but less so in SOLVIT, a network related to the Internal Market

How European administrative networks aid the implementation and enforcement of EU policies

European Administrative Networks are networks of national actors who interact to improve the implementation and enforcement of EU policies. Drawing on new research, Dorte Sindbjerg Martinsen, Reini Schrama and Ellen Mastenbroek illustrate the role and structure of these networks, together with some of their key limitations

First documentation of malaria parasites (genus Plasmodium) in the Saltmarsh Sparrow (Ammodramus caudacutus) and patterns of infection with mercury exposure

Avian malaria parasites, protist parasites of the genus Plasmodium, are extremely common in birds worldwide and have the ability to dramatically impact sensitive populations and species. Mercury, a heavy metal that accumulates in the tissues of birds, is a common environmental pollutant that may reduce immune system function and increase susceptibility to malaria parasite infection. I surveyed the endangered Saltmarsh Sparrow (Ammodramus caudacutus), a species with high exposure to mercury, for malaria parasites. Specifically, I investigated the presence, diversity, and distribution of malaria parasites in the species, the degree of sharing of parasite lineages with other bird species, and the relationship between blood mercury levels and infection status. Through collaboration with researchers at the Biodiversity Research Institute (BRI) and the University of New Hampshire (UNH), blood samples were collected from 290 individuals across the entire breeding range of the species from Maine to Maryland, U.S. By sensitive nested PCR methods, I screened each sample for malaria parasite infection and each positive infection was sequenced at the mitochondrial cytochrome b gene to identify parasite lineages, the standard gene used in defining Plasmodium lineages. Overall, 16.5% of Saltmarsh Sparrows were found to be infected with a total of six Plasmodium lineages. Prevalence and diversity of parasite lineages varied across the breeding range of the Saltmarsh Sparrow, with greater prevalence and diversity in northern states. The skewed distribution of prevalence and parasite diversity may be due to mosquito control measures, habitat type, or possibly climate change. All six parasite lineages were found to be shared with other passerine species including those also found to nest in or near saltmarshes. Blood mercury levels varied in the Saltmarsh Sparrow, ranging from 0.18 ppm to 2.52 ppm with a mean of 0.86 ppm. Although a positive correlation was expected between blood mercury levels and infection status because mercury negatively impacts an individual’s ability to fight infection, I found a negative correlation. These results suggest that individuals with low blood mercury levels are more likely to be infected with malaria parasites. The discovery of a relatively high prevalence and diversity of malaria parasites in the Saltmarsh Sparrow, a species in rapid decline across its range, and the negative correlation relationship between mercury exposure and malaria parasite infection status, suggest the need for continued study of malaria parasite dynamics in the species. Further research will help elucidate the link between environmental pollution and infectious disease risk, which is a pressing topic as environmental contamination combined with climate change may heavily impact host, vector, and parasite distributions and host-parasite dynamics

The polyphyly of Plasmodium: Comprehensive phylogenetic analyses of the malaria parasites (Order Haemosporida) reveal widespread taxonomic conflict

© 2018 The Authors. The evolutionary relationships among the apicomplexan blood pathogens known as the malaria parasites (order Haemosporida), some of which infect nearly 200 million humans each year, has remained a vexing phylogenetic problem due to limitations in taxon sampling, character sampling and the extreme nucleotide base composition biases that are characteristic of this clade. Previous phylogenetic work on the malaria parasites has often lacked sufficient representation of the broad taxonomic diversity within the Haemosporida or the multi-locus sequence data needed to resolve deep evolutionary relationships, rendering our understanding of haemosporidian lifehistory evolution and the origin of the human malaria parasites incomplete. Here we present the most comprehensive phylogenetic analysis of the malaria parasites conducted to date, using samples from a broad diversity of vertebrate hosts that includes numerous enigmatic and poorly known haemosporidian lineages in addition to genome-wide multi-locus sequence data. We find that if base composition differences were corrected for during phylogenetic analysis, we recovered a well-supported topology indicating that the evolutionary history of the malaria parasites was characterized by a complex series of transitions in life-history strategies and host usage. Notably we find that Plasmodium, the malaria parasite genus that includes the species of human medical concern, is polyphyletic with the life-history traits characteristic of this genus having evolved in a dynamic manner across the phylogeny. We find support for multiple instances of gain and loss of asexual proliferation in host blood cells and production of haemozoin pigment, two traits that have been used for taxonomic classification as well as considered to be important factors for parasite virulence and used as drug targets. Lastly, our analysis illustrates the need for a widespread reassessment of malaria parasite taxonomy

Implementation fidelity in a complex intervention promoting psychosocial well-being following stroke: an explanatory sequential mixed methods study

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Nurses’ and occupational therapists’ experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation

Background: Persons with stroke are susceptible to psychosocial problems, and express disappointment at how health care professionals fail to meet their psychosocial needs following discharge to home. The responsibility of nurses and occupational therapists in stroke rehabilitation is to assist the persons and their families during the recovery and adjustment process. A home-based dialogical intervention aiming to enhance psychosocial support was therefore developed and tested in a randomized controlled trial. This study is a part of the process evaluation conducted alongside the trial. The aim was to explore the nurses’ and occupational therapists’ experiences of conducting the intervention. Methods: Eighteen nurses and four occupational therapists participated in six focus groups to explore their experiences when providing the intervention. The themes discussed in the focus groups were the aspects that facilitated the delivering of the intervention and the challenges they encountered during the study period. The interviews were analysed using qualitative content analysis. Results: The analysis generated two themes. The theme Developing a supportive relationship to facilitate the adjustment process following stroke had two subthemes: Getting personally involved and Handling challenges. This theme reveals how the nurses and occupational therapists experienced their relationship with the persons with stroke and potential threats which challenged them while conducting the intervention. The theme Developing professional skills in providing psychosocial support had two subthemes: Becoming confident in conducting dialogues and Integrating psychosocial topics. This theme reveals the aspects that the nurses and occupational therapists perceived as facilitating the development of their professional skills in conducting the dialogues. Conclusion: Delivering the psychosocial intervention was perceived as deeply meaningful and increased the nurses’ and occupational therapists’ understanding of how to support stroke survivors to live with the consequences of stroke. However, balancing the professional and the personal relationship was challenging. A basic educational programme, training, supervision and having dedicated time were crucial elements to instil confidence in professionals conducting theme-based dialogues to promote post-stroke psychosocial well-being. Individual clinical experience and knowledge of stroke care were considering important to enable professionals to integrate psychosocial rehabilitation into community health care.publishedVersio

Perceived study-induced influence on the control group in a randomized controlled trial evaluating a complex intervention to promote psychosocial well-being after stroke: a process evaluation

Background A commonly applied control condition in trials evaluating complex interventions in rehabilitation research is “usual care.” The main challenge is to ensure that the control group receives genuine usual care as delivered in everyday clinical practice. The assessment interviews and dialogues with the data collectors may influence the control group participants’ reflections on their condition and adjustments. This represents a threat to the internal validity of the trial. Thus, the aim of this study was to explore the perceived study-induced influence of assessment interviews on the adjustment of the members of a control group in a randomized clinical trial. The aim of the trial was to test a dialogue-based psychosocial intervention aiming at promoting the psychosocial well-being and adjustment of stroke survivors. Methods Fifteen participants in the control group of a multicenter stroke rehabilitation trial participated in narrative semi-structured interviews. Ricoeur’s interpretation theory guided the analysis. Results The perceived study-induced influence of the assessment interviews on the adjustment process of members of the control group varied considerably. The results demonstrated that the assessment interviews facilitated some participants’ feelings of control and their ability to cope. Other participants’ statements indicate that they relied on their existing personal capacity to cope and adjust and that the assessment interviews did not make any difference either on their coping ability or on their process of adjustment. Five themes were identified that described the perceived study-induced influence of the assessment interviews in the control group. The themes illustrated that the assessments served as a safety net, enhanced awareness and understanding, encouraged seeking support, allowed the opportunity to vent disappointment, or did not make any difference either way. Conclusions RCT assessment interviews may influence the adjustment process and represent a serious problem in measuring interventions over time in trials of complex interventions in rehabilitation research. To uphold rigor and stringency, the usual care control conditions should be thoroughly assessed and described. Informing participants only about the treatment they were allocated to receive might counteract the potential to dilute the difference between the two arms of the trial

Promoting psychosocial well-being following stroke: study protocol for a randomized, controlled trial

Source at https://doi.org/10.1186/s40359-018-0223-6.Background: Stroke is a major public health threat globally. Psychosocial well-being may be affected following stroke. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent. Approximately one third report depressive symptoms and 20% report anxiety during the first months or years after the stroke. Psychosocial difficulties may impact significantly on long-term functioning and quality of life, reduce the effects of rehabilitation services and lead to higher mortality rates. The aim of the study is to evaluate the effect of a previously developed and feasibility tested dialogue-based psychosocial intervention aimed at promoting psychosocial well-being and coping following stroke among stroke survivors with and without aphasia. Methods: The study will be conducted as a multicenter, randomized, single blind controlled trial with one intervention and one control arm. It will include a total of 330 stroke survivors randomly allocated into either an intervention group (dialogue-based intervention to promote psychosocial well-being) or a control group (usual care). Participants in the intervention group will receive eight individual sessions of supported dialogues in their homes during the first six months following an acute stroke. The primary outcome measure will be psychosocial well-being measured by the General Health Questionnaire (GHQ). Secondary outcome measures will be quality of life (SAQoL), sense of coherence (SOC), and depression (Yale). Process evaluation will be conducted in a longitudinal mixed methods study by individual qualitative interviews with 15–20 participants in the intervention and control groups, focus group interviews with the intervention personnel and data collectors, and a comprehensive analysis of implementation fidelity. Discussion: The intervention described in this study protocol is based on thorough development and feasibility work, guided by the UK medical research council framework for developing and testing complex interventions. It combines classical effectiveness evaluation with a thorough process evaluation. The results from this study may inform the development of further trials aimed at promoting psychosocial well-being following stroke as well as inform the psychosocial follow up of stroke patients living at home. Trial registration: NCT02338869; registered 10/04/2014 (On-going trial).</p

Malaria parasites (Plasmodium spp.) infecting introduced, native and endemic New Zealand birds

Avian malaria is caused by intracellular mosquito-transmitted protist parasites in the order Haemosporida, genus Plasmodium. Although Plasmodium species have been diagnosed as causing death in several threatened species in New Zealand, little is known about their ecology and epidemiology. In this study, we examined the presence, microscopic characterization and sequence homology of Plasmodium spp. isolates collected from a small number of New Zealand introduced, native and endemic bird species. We identified 14 Plasmodium spp. isolates from 90 blood or tissue samples. The host range included four species of passerines (two endemic, one native, one introduced), one species of endemic pigeon and two species of endemic kiwi. The isolates were associated into at least four distinct clusters including Plasmodium (Huffia) elongatum, a subgroup of Plasmodium elongatum, Plasmodium relictum and Plasmodium (Noyvella) spp. The infected birds presented a low level of peripheral parasitemia consistent with chronic infection (11/15 blood smears examined). In addition, we report death due to overwhelming parasitemia in a blackbird, a great spotted kiwi and a hihi. These deaths were attributed to infections with either Plasmodium spp. lineage LINN1 or P. relictum lineage GRW4. To the authors’ knowledge, this is the first published report of Plasmodium spp. infection in great spotted and brown kiwi, kereru and kokako. Currently, we are only able to speculate on the origin of these 14 isolates but consideration must be made as to the impact they may have on threatened endemic species, particularly due to the examples of mortality

Oil Price Shocks and the Norwegian Effective Exchange Rate – an SVAR Approach

We employ a structural VAR model to investigate direct and indirect effects of oil price changes on the Norwegian effective exchange rate (I44). The model is estimated on different subsamples and with different model specifications. Our main finding is that the direct effect of oil price shocks on the I44 has increased over time, independent of the model specification we choose. Furthermore, an increasing impact of oil shocks on interest rates and an increased impact of interest rates on the I44 account for the rise in the indirect impact of oil on the I44 over time. We further find that long (short) term interest differentials become relatively more (less) important for explaining movements in the I44 during recent samples. A possible interpretation could be the (zero) lower bound and unconventional monetary policy conducted by Norway’s trading partners