Missed opportunities for measles immunisation in selected western Cape hosl?itals

Measles is still a major cause of childhood mortality and morbidity in South Africa. The World Health Organisation (WHO) has recently recommended that greater a"ention be paid to opportunities for immunisation in the curative sector. This study quantified the extent of missed opportunities for measles immunisation in children a"ending primary, secondary and tertiary level curative hospitals in the western Cape. Exit interviews of 1 068 carers of children aged between 6 and 59 months inclusive showed that 2,4 - 40,7% of carers had been requested to produce a Road-to-Health card, and that 4,8 - 43,1% of carers had a card available. The proportion of children with documented evidence of measles immunisation available ranged from 4,8% to 40,0% between facilities. The study demonstrated that a considerable number of potential opportunities to immunise children against measles are currently being missed in children a"ending hospitals and day hospitals in the western Cape. The study documents the effect of a fragmented approach to health care, and'indicates a need for rapid integration of preventive and curative components of health care into a metropolitan-based primary health care service

A nonlinear hydrodynamical approach to granular materials

We propose a nonlinear hydrodynamical model of granular materials. We show how this model describes the formation of a sand pile from a homogeneous distribution of material under gravity, and then discuss a simulation of a rotating sandpile which shows, in qualitative agreement with experiment, a static and dynamic angle of repose.Comment: 17 pages, 14 figures, RevTeX4; minor changes to wording and some additional discussion. Accepted by Phys. Rev.

A Neptune-mass exoplanet in close orbit around a very low-mass star challenges formation models

Stars and planetary system

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol�which is a marker of cardiovascular risk�changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95 credible interval 3.7 million�4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world. © 2020, The Author(s), under exclusive licence to Springer Nature Limited

Importance of trophic information, simplification and aggregation error in ecosystem models

Ecosystem models are becoming increasingly important as pressure from fisheries intensifies and ecosystem-based fisheries management becomes more widely used. Trophic webs often form the basis of ecosystem models and ecosystem-specific dietary information is crucial for optimal model performance. This is particularly the case if model predictions are used in management decisions. The Tasmanian live fish fishery for banded morwong was used as a case study to investigate the importance of trophic information, model simplification and aggregation error on ecosystem model results. Dietary analysis of 6 commonly captured reef fish was undertaken. Significant trophic overlap was found between blue throat wrasse Notolabrus tetricus and purple wrasse N. fucicola, and banded morwong Cheilodactylus spectabilis and bastard trumpeter Latridopsis forsten. Marblefish Aplodactylus arctidens and long-snouted boarfish Pentaceropsis recurvirostris had significantly different diets from other species studied. Using this information, a detailed qualitative model was produced and then simplified through the aggregation of variables. Variables were aggregated using 3 methods: Euclidean distance, Bray-Curtis similarity, and regular equivalence for inclusion in 3 simplified models. Variable aggregation is undertaken in many studies and may create aggregation error. Each aggregation method produced a different proportion of incorrect model predictions as a result of aggregation error. The model simplified using regular equivalence produced the least aggregation error and a web structure aligned with the dietary analysis. More widespread use of these methods in fisheries management should be considered