Promoting Evidence-Based Childhood Fever Management Through a Peer Education Programme Based on the Theory of Planned Behaviour

ABSTRACT Aims and Objectives This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management. Background Paediatric nurses’ inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the Theory of Planned Behavior (TPB), were belief-based attitudes and subjective norms. Design A quasi-experiment explored group effects of a Peer Education Program, based on the TPB, on factors influencing paediatric nurses’ antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months post Peer Education Program. Methods All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The Peer Education Program (PEP) consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions. Results Two-way univariate ANOVAs explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p=0.01) and intentions (p=0.01), a significant main group effect in control influence (p=0.01) and a significant main effect between audit data across time points (p=0.03) highlight PEP effectiveness in behaviour change. Normative, control and intention changes post PEP were maintained in latency data; mean temperature was not. Conclusion The PEP, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management. Relevance to Clinical Practice The promotion of evidence-based change in organisational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes

SNAP-Ed New Mexico Social Marketing Campaign Phase 1 Focus Groups Report

The purpose of the SNAP-Ed New Mexico Social Marketing Campaign is to develop and evaluate culturally appropriate nutrition education intervention messages in Spanish for parents and care-givers of preschool age children, parents of elementary school-age children, and children ages 8-10 years. In collaboration with HSD, the University of New Mexico Prevention Research Center (PRC) set out to develop and test messages to effectively motivate SNAP participants who do not currently meet U.S. Dietary Guidelines recommendations for consumption of fruits, vegetables, whole-grains and low-fat dairy to increase their intake of these foods. This is a three phase project. Phase one of the project was the planning phase and consisted of conducting focus groups with Spanish speaking SNAP eligible individuals to identify the concepts in which the messages for this specific population would be based. This formative research phase was carried out from January 2010 until June 2011.https://digitalrepository.unm.edu/prc-fr/1000/thumbnail.jp

Assessing Disparities of Dengue Virus Transmission Risk across the US-Mexican Border Using a Climate Driven Vector-Epidemiological Model

Dengue fever is a mosquitoborne viral disease reemerging throughout much of the tropical Americas. Dengue virus transmission is explicitly influenced by climate and the environment through its primary vector, Aedes aegypti. Temperature regulates Ae. aegypti development, survival, and replication rates as well as the incubation period of the virus within the mosquito. Precipitation provides water for many of the preferred breeding habitats of the mosquito, including buckets, old tires, and other places water can collect. Although transmission regularly occurs along the border region in Mexico, dengue virus transmission in bordering Arizona has not occurred. Using NASA's TRMM (Tropical Rainfall Measuring Mission) satellite for precipitation input and Daymet for temperature and supplemental precipitation input, we modeled dengue transmission along a USMexico transect using a dynamic dengue transmission model that includes interacting vector ecology and epidemiological components. Model runs were performed for 5 cities in Sonora, Mexico and southern Arizona. Employing a Monte Carlo approach, we performed ensembles of several thousands of model simulations in order to resolve the model uncertainty arising from using different combinations of parameter values that are not well known. For cities with reported dengue case data, the top model simulations that best reproduced dengue case numbers were retained and their parameter values were extracted for comparison. These parameter values were used to run simulations in areas where dengue virus transmission does not occur or where dengue fever case data was unavailable. Additional model runs were performed to reveal how changes in climate or parameter values could alter transmission risk along the transect. The relative influence of climate variability and model parameters on dengue virus transmission is assessed to help public health workers prepare location specific infection prevention strategies

SNAP-Ed New Mexico Social Marketing Campaign Phase 1 Report

The Supplemental Nutrition Assistance Program (SNAP) of the United States Department of Agriculture (USDA) plays an essential role in the nutrition status of low-income families in the United States. Although it is not mandatory to provide nutrition education to SNAP recipients, USDA’s Food and Nutrition Service (FNS) highly encourages each state’s SNAP agency to educate SNAP participants (SNAP-Ed). The purpose of SNAP-Ed is to help SNAP eligible individuals to make healthy food choices consistent with the 2010 Dietary Guidelines for Americans, that fit within their limited budget. In New Mexico, SNAP and SNAP-Ed are administered by the State of New Mexico Human Services Department (HSD). FNS guides states to choose the most effective nutrition education tools and strategies to meet the focus of SNAP-Ed. FNS encourages state plans to include “behaviorally focused, sciencebased nutrition education interventions, projects or social marketing campaigns” [1]. Social Marketing is defined as a consumerfocused, research-based process to plan, implement and evaluate interventions that are designed to influence the voluntary behavior of a large number of people in the target audience [1]. The purpose of the SNAP-Ed New Mexico Social Marketing Campaign is to develop and evaluate culturally appropriate nutrition education intervention messages in Spanish for parents and care-givers of preschool age children, parents of elementary school-age children, and children ages 8-10 years. In collaboration with HSD, the University of New Mexico Prevention Research Center (PRC) set out to develop and test messages to effectively motivate SNAP participants who do not currently meet U.S. Dietary Guidelines recommendations for consumption of fruits, vegetables, whole-grains and low-fat dairy to increase their intake of these foods. This is a three phase project. Phase one of the project was the planning phase and consisted of conducting focus groups with Spanish speaking SNAP eligible individuals to identify the concepts in which the messages for this specific population would be based. This formative research phase was carried out from January 2010 until June 2011. Focus groups were conducted with a) parents of preschool children, b) parents of elementary school-age children, and c) children ages 8-10. The goal was to have SNAP-eligible, Spanish speaking parents and children develop “slogans” and “messages” which would resonate with them and their neighbors and encourage families to make healthy food choices. This report outlines the methods used for the focus groups; results from the focus groups with emergent themes and direct quotes from participants; discussion of findings and implications for SNAP-Ed; connections with the consumer-tested FNS Core Nutrition Messages; and next steps for phases two and three of the campaign

On the Seasonal Occurrence and Abundance of the Zika Virus Vector Mosquito Aedes Aegypti in the Contiguous United States

Introduction: An ongoing Zika virus pandemic in Latin America and the Caribbean has raised concerns that travel-related introduction of Zika virus could initiate local transmission in the United States (U.S.) by its primary vector, the mosquito Aedes aegypti. Methods: We employed meteorologically driven models for 2006-2015 to simulate the potential seasonal abundance of adult Aedes aegypti for fifty cities within or near the margins of its known U.S. range. Mosquito abundance results were analyzed alongside travel and socioeconomic factors that are proxies of viral introduction and vulnerability to human-vector contact. Results: Meteorological conditions are largely unsuitable for Aedes aegypti over the U.S. during winter months (December-March), except in southern Florida and south Texas where comparatively warm conditions can sustain low-to-moderate potential mosquito abundance. Meteorological conditions are suitable for Aedes aegypti across all fifty cities during peak summer months (July-September), though the mosquito has not been documented in all cities. Simulations indicate the highest mosquito abundance occurs in the Southeast and south Texas where locally acquired cases of Aedes-transmitted viruses have been reported previously. Cities in southern Florida and south Texas are at the nexus of high seasonal suitability for Aedes aegypti and strong potential for travel-related virus introduction. Higher poverty rates in cities along the U.S.-Mexico border may correlate with factors that increase human exposure to Aedes aegypti. Discussion: Our results can inform baseline risk for local Zika virus transmission in the U.S. and the optimal timing of vector control activities, and underscore the need for enhanced surveillance for Aedes mosquitoes and Aedes-transmitted viruses

Cambio climático y dengue: una aproximación sistémica

Ponencia presentada en: IX Congreso de la Asociación Española de Climatología celebrado en Almería entre el 28 y el 30 de octubre de 2014.[ES]Tanto el cambio global como el cambio climático están impactando de manera directa en la presencia y abundancia de vectores transmisores de enfermedades; esta hipótesis debe ser contrastada con datos climatológicos, entomológicos y sociales a fin de poder establecer escenarios de actuación o riesgo ante la presencia del vector. El dengue es la enfermedad trasmitida por vectores con mayor presencia en regiones tropicales. Se ha desarrollado una investigación de 2010 a 2013 donde se ha estudiado la presencia del mosquito Aedes aegypti en un transecto altitudinal del nivel del mar hasta los 2100 m.s.n.m. en la parte central del golfo de México. La presencia del vector no sólo está asociada con la temperatura sino con factores socio-ambientales. Estimar el acoplamiento entre los tres sub-sistemas mencionados provee un marco metodológico y conceptual para valorar un posible escenario futuro ante el calentamiento del sistema climático.[EN]Global changes as well as climate change are impacting directly the presence and abundance of disease vectors; in particular, this hypothesis should be contrasted with climatological, entomological and social data in order to establish performance or risk scenarios in presence of vector. Dengue is a vector-born disease with greater presence in tropical regions. It has developed a research from 2010 to 2013 where it has studied the presence of mosquito Aedes aegypti in an altitudinal transect from sea level to 2100 m.a.s.l. in the central part of the Gulf of Mexico. The presence of the vector is associated not only with temperature but also with socio-environmental factors. Estimate the coupling among the three systems mentioned provides a methodological and conceptual framework to evaluate a possible future scenario coping the warming of the climate system

Correlating Remote Sensing Data with the Abundance of Pupae of the Dengue Virus Mosquito Vector, Aedes aegypti, in Central Mexico

Using a geographic transect in Central Mexico, with an elevation/climate gradient, but uniformity in socio-economic conditions among study sites, this study evaluates the applicability of three widely-used remote sensing (RS) products to link weather conditions with the local abundance of the dengue virus mosquito vector, Aedes aegypti (Ae. aegypti). Field-derived entomological measures included estimates for the percentage of premises with the presence of Ae. aegypti pupae and the abundance of Ae. aegypti pupae per premises. Data on mosquito abundance from field surveys were matched with RS data and analyzed for correlation. Daily daytime and nighttime land surface temperature (LST) values were obtained from Moderate Resolution Imaging Spectroradiometer (MODIS)/Aqua cloud-free images within the four weeks preceding the field survey. Tropical Rainfall Measuring Mission (TRMM)-estimated rainfall accumulation was calculated for the four weeks preceding the field survey. Elevation was estimated through a digital elevation model (DEM). Strong correlations were found between mosquito abundance and RS-derived night LST, elevation and rainfall along the elevation/climate gradient. These findings show that RS data can be used to predict Ae. aegypti abundance, but further studies are needed to define the climatic and socio-economic conditions under which the correlations observed herein can be assumed to apply

Riesgo potencial por cambio climático y vectores. Factores locales de ciudad: uso de suelo y vegetación

Ponencia presentada en: X Congreso de la Asociación Española de Climatología celebrado en Alicante entre el 5 y el 8 de octubre de 2016.[ES]El cambio climático está relacionado con la presencia y abundancia de vectores, en particular con Aedes aegypti (responsable de la trasmisión de dengue, chikungunya y zika) a nivel urbano; nuestra hipótesis asocia la presencia del vector con la climatología y factores socio-ambientales tales como el uso de suelo y la vegetación en espacios urbanos, mismos que inciden en favorecer un hábitat para el vector. Estudiamos una región tropical en la parte central del golfo de México desde los 0 y hasta los 2200 m.s.n.m., ya que es un reto observar el acoplamiento entre los sistemas mencionados para estimar un posible escenario de riesgo presente y futuro ante el calentamiento del sistema climático. Se usan datos de la investigación de 2011 a 2014, donde se ha estudiado la presencia de Aedes aegypti en un transecto altitudinal, con datos de factores urbanos para observar el acoplamiento entre dichas variables por medios estadísticos.[EN]The climatic change is related with the vector presence and abundance, particularly with Aedes aegypti (responsible of dengue, chikungunya and zika transmission) at urban level; our hypothesis associate vector presence with socio-environmental factors and climatology, as land use and vegetation in urban areas, these provide easily a vector habitat. We studied a tropical region on the central Gulf of México from 0 to 2200 meters above sea level, due to the challenge of coupled with the factors mentioned before, in order to estimate a possible risk scenario present or future associated at global warming. We use research data from 2011 to 2014, in which we studied the presence of Aedes on altitude transect, with urban data to observe trough statistical methods variables coupling

Riesgo potencial por cambio climático y vectores. Factores locales de ciudad: uso de suelo y vegetación

El cambio climático está relacionado con la presencia y abundancia de vectores, en particular con Aedes aegypti (responsable de la trasmisión de dengue, chikungunya y zika) a nivel urbano; nuestra hipótesis asocia la presencia del vector con la climatología y factores socio-ambientales tales como el uso de suelo y la vegetación en espacios urbanos, mismos que inciden en favorecer un hábitat para el vector. Estudiamos una región tropical en la parte central del golfo de México desde los 0 y hasta los 2200 m.s.n.m., ya que es un reto observar el acoplamiento entre los sistemas mencionados para estimar un posible escenario de riesgo presente y futuro ante el calentamiento del sistema climático. Se usan datos de la investigación de 2011 a 2014, donde se ha estudiado la presencia de Aedes aegypti en un transecto altitudinal, con datos de factores urbanos para observar el acoplamiento entre dichas variables por medios estadísticos.The climatic change is related with the vector presence and abundance, particularly with Aedes aegypti (responsible of dengue, chikungunya and zika transmission) at urban level; our hypothesis associate vector presence with socio-environmental factors and climatology, as land use and vegetation in urban areas, these provide easily a vector habitat. We studied a tropical region on the central Gulf of México from 0 to 2200 meters above sea level, due to the challenge of coupled with the factors mentioned before, in order to estimate a possible risk scenario present or future associated at global warming. We use research data from 2011 to 2014, in which we studied the presence of Aedes on altitude transect, with urban data to observe trough statistical methods variables coupling

Monogenic conditions and central nervous system anomalies:A prospective study, systematic review and meta-analysis

Objectives: Determine the incremental diagnostic yield of prenatal exome sequencing (pES) over chromosome microarray (CMA) or G-banding karyotype in fetuses with central nervous system (CNS) abnormalities.Methods: Data were collected via electronic searches from January 2010 to April 2022 in MEDLINE, Cochrane, Web of Science and EMBASE. The NHS England prenatal exome cohort was also included. Incremental yield was calculated as a pooled value using a random-effects model. Results: Thirty studies were included (n = 1583 cases). The incremental yield with pES for any CNS anomaly was 32% [95%CI 27%–36%; I2 = 72%]. Subgroup analysis revealed apparent incremental yields in; (a) isolated CNS anomalies; 27% [95%CI 19%–34%; I2 = 74%]; (b) single CNS anomaly; 16% [95% CI 10%–23%; I2 = 41%]; (c) more than one CNS anomaly; 31% [95% Cl 21%–40%; I2 = 56%]; and (d) the anatomical subtype with the most optimal yield was Type 1 malformation of cortical development, related to abnormal cell proliferation or apoptosis, incorporating microcephalies, megalencephalies and dysplasia; 40% (22%–57%; I2 = 68%). The commonest syndromes in isolated cases were Lissencephaly 3 and X-linked hydrocephalus. Conclusions: Prenatal exome sequencing provides a high incremental diagnostic yield in fetuses with CNS abnormalities with optimal yields in cases with multiple CNS anomalies, particularly those affecting the midline, posterior fossa and cortex.</p