Evaluating the Peer Education Project in secondary schools

Purpose The purpose of this paper is to determine the efficacy of the Peer Education Project (PEP), a school-based, peer-led intervention designed to support secondary school students to develop the skills and knowledge they need to safeguard their mental health and that of their peers. Design/methodology/approach Six schools from across England and the Channel Islands took part in an evaluation of the PEP across the 2016/2017 academic year. In total, 45 trained peer educators from the sixth form and 455 Year 7 students completed pre- and post-questionnaires assessing their emotional and behavioural difficulties, perceived school climate, and knowledge, skills and confidence related to mental health. Findings Results indicate that participation in the PEP is associated with significant improvement in key skills among both peer educators and student trainees, and in understanding of key terms and readiness to support others among trainees. Most students would recommend participation in the programme to other students. Originality/value While peer education has been found to be effective in some areas of health promotion, research on the effectiveness of peer-led mental health education programmes in schools is limited. This study contributes evidence around the efficacy of a new peer education programme that can be implemented in secondary schools. </jats:sec

Household Transmission of Leptospira Infection in Urban Slum Communities

Leptospirosis has emerged to become an urban slum health problem. Epidemics of severe leptospirosis, characterized by jaundice, acute renal failure and haemorrhage, are now reported in cities throughout the developing world due to rapid expansion of slum settlements, which in turn has produced the ecological conditions for rodent-borne transmission of the spirochete pathogen. A survey was performed in the city of Salvador, Brazil, to determine whether the risk of Leptospira infection clustered in households within slum communities in which a member had developed severe leptospirosis. We found that members of households with an index case of leptospirosis had more than five times the risk of having serologic evidence for a prior infection than members of neighbourhood households in the same communities. Increased risk of infection was found among all age groups who resided in these households. The finding that Leptospira infection clusters in specific slum households indicates that the factors associated with this environment are important determinants for transmission. Further research is needed to identify the sources of contamination and risk exposures which occur in the places where slum inhabitants reside such that effective community-based prevention of urban leptospirosis can be implemented

Socio-economic factors associated with loss to follow-up among individuals with HCV:A Dutch nationwide cross-sectional study

Background and Aims: The path to hepatitis C virus (HCV) elimination is complicated by individuals who become lost to follow-up (LTFU) during care, particularly before receiving effective HCV treatment. We aimed to determine factors contributing to LTFU and whether LTFU is associated with mortality. Methods: In this secondary analysis, we constructed a database including individuals with HCV who were either LTFU (data from the nationwide HCV retrieval project, CELINE) or treated with directly acting antivirals (DAA) (data from Statistics Netherlands) between 2012 and 2019. This database was linked to mortality data from Statistics Netherlands. Determinants associated with being LTFU versus DAA-treated were assessed using logistic regression, and mortality rates were compared between groups using exponential survival models. These analyses were additionally stratified on calendar periods: 2012–2014, 2015–2017 and 2018–2019. Results: About 254 individuals, LTFU and 5547 DAA-treated were included. Being institutionalized (OR = 5.02, 95% confidence interval (CI) = 3.29–7.65), household income below the social minimum (OR = 1.96, 95% CI = 1.25–3.06), receiving benefits (OR = 1.74, 95% CI = 1.20–2.52) and psychiatric comorbidity (OR = 1.51, 95% CI = 1.09–2.10) were associated with LTFU. Mortality rates were significantly higher in individuals LTFU compared to those DAA-treated (2.99 vs. 1.15/100 person-years (PY), p &lt;.0001), while in those DAA-treated, mortality rates slowly increased between 2012–2014 (.22/100PY) and 2018–2019 (2.25/100PY). Conclusion: In the Netherlands, individuals who are incarcerated/institutionalized, with low household income, or with psychiatric comorbidities are prone to being LTFU, which is associated with higher mortality. HCV care needs to be adapted for these vulnerable individuals.</p

Structure-Specific Fermentation of Galacto-Oligosaccharides, Isomalto-Oligosaccharides and Isomalto/Malto-Polysaccharides by Infant Fecal Microbiota and Impact on Dendritic Cell Cytokine Responses

SCOPE: Next to galacto-oligosaccharides (GOS), starch-derived isomalto-oligosaccharide preparation (IMO) and isomalto/malto-polysaccharides (IMMP) could potentially be used as prebiotics in infant formulas. However, it remains largely unknown how the specific molecular structures of these non-digestible carbohydrates (NDCs) impact fermentability and immune responses in infants. METHODS AND RESULTS: In vitro fermentation of GOS, IMO and IMMP using infant fecal inoculum of 2- and 8-week-old infants showed that only GOS and IMO were fermented by infant fecal microbiota. The degradation of GOS and IMO coincided with an increase in Bifidobacterium and production of acetate and lactate, which was more pronounced with GOS. Individual isomers with an (1↔1)-linkage or di-substituted reducing terminal glucose residue were more resistant to fermentation. GOS, IMO and IMMP fermentation digesta attenuated cytokine profiles in immature dendritic cells (DCs), but the extent was dependent on the infants age and NDC structure. CONCLUSION: The IMO preparation, containing reducing and non-reducing isomers, showed similar fermentation patterns as GOS in fecal microbiota of 2-week-old infants. Knowledge obtained on the substrate specificities of infant fecal microbiota and the subsequent regulatory effects of GOS, IMO and IMMP on DC responses might contribute to the design of tailored NDC mixtures for infants of different age groups. This article is protected by copyright. All rights reserved

The \u2018COmorBidity in Relation to AIDS\u2019 (COBRA) cohort: Design, methods and participant characteristics

Background Persons living with HIV on combination antiretroviral therapy (cART) may be at increased risk of the development of age-associated non-communicable comorbidities (AANCC) at relatively young age. It has therefore been hypothesised that such individuals, despite effective cART, may be prone to accelerated aging. Objective The COmorBidity in Relation to AIDS (COBRA) cohort study was designed to investigate the potential causal link between HIV and AANCC, amongst others, in a cohort of middle-aged individuals with HIV with sustained viral suppression on cART and otherwise comparable HIV-negative controls. Methods Longitudinal cohort study of HIV-positive subjects 45 years of age, with sustained HIV suppression on cART recruited from two large European HIV treatment centres and similarly-aged HIV-negative controls recruited from sexual health centres and targeted community groups. Both HIV-positive and HIV-negative subjects were assessed at study entry and again at follow-up after 2 years. Results Of the 134 HIV-positive individuals with a median (IQR) age of 56 (51, 62) years recruited, 93% were male, 88% of white ethnicity and 86% were men who have sex with men (MSM). Similarly, the 79 HIV-negative subjects had a median (IQR) age of 57 (52, 64) and 92% were male, 97% of white ethnicity and 80% were MSM. Conclusions The results from the COBRA study will be a significant resource to understand the link between HIV and AANCC and the pathogenic mechanisms underlying this link. COBRA will inform future development of novel prognostic tools for earlier diagnosis of AANCC and of novel interventions which, as an adjunct to cART, may prevent AANCC

Large carbon sink potential of secondary forests in the Brazilian Amazon to mitigate climate change

Tropical secondary forests sequester carbon up to 20 times faster than old-growth forests. This rate does not capture spatial regrowth patterns due to environmental and disturbance drivers. Here we quantify the influence of such drivers on the rate and spatial patterns of regrowth in the Brazilian Amazon using satellite data. Carbon sequestration rates of young secondary forests (<20 years) in the west are ~60% higher (3.0 ± 1.0 Mg C ha−1 yr−1) compared to those in the east (1.3 ± 0.3 Mg C ha−1 yr−1). Disturbances reduce regrowth rates by 8–55%. The 2017 secondary forest carbon stock, of 294 Tg C, could be 8% higher by avoiding fires and repeated deforestation. Maintaining the 2017 secondary forest area has the potential to accumulate ~19.0 Tg C yr−1 until 2030, contributing ~5.5% to Brazil’s 2030 net emissions reduction target. Implementing legal mechanisms to protect and expand secondary forests whilst supporting old-growth conservation is, therefore, key to realising their potential as a nature-based climate solution

Do we need universal competence in space

В данной статье рассматривается вопрос влияния личностных качеств на профессиональную деятельность. К чему может привести отсутствие компетенций? Какими качествами должен обладать космонавт - испытатель? Проведен анализ трудовых функций космонавта - испытателя, и по этим данным подобраны универсальные компетенции космонавта, находящегося в космосе. Универсальные компетенции - это качества личности, от которых зависит ее успех практически во всех областях профессиональной деятельности.This article discusses the question of the impact of personal qualities on professional activities. What can be due to lack of competencies? What are the qualities of a test cosmonaut? The analysis of the job functions of test - cosmonaut on this data selected generic competence astronaut is in space. Universal jurisdiction is the quality of the person depends on its success in almost all areas of professional activity

Increased brain-predicted aging in treated HIV disease

Objective: To establish whether HIV disease is associated with abnormal levels of age-related brain atrophy, by estimating apparent brain age using neuroimaging and exploring whether these estimates related to HIV status, age, cognitive performance, and HIV-related clinical parameters. Methods: A large sample of virologically suppressed HIV-positive adults (n = 162, age 45-82 years) and highly comparable HIV-negative controls (n = 105) were recruited as part of the Comorbidity in Relation to AIDS (COBRA) collaboration. Using T1-weighted MRI scans, a machinelearning model of healthy brain aging was defined in an independent cohort (n = 2,001, aged 1890 years). Neuroimaging data from HIV-positive and HIV-negative individuals were then used to estimate brain-predicted age; then brain-predicted age difference (brain-PAD 5 brain-predicted brain age 2 chronological age) scores were calculated. Neuropsychological and clinical assessments were also carried out. Results: HIV-positive individuals had greater brain-PAD score (mean +/- SD 2.15 +/- 7.79 years) compared to HIV-negative individuals (20.87 +/- 8.40 years; b = 3.48, p < 0.01). Increased brainPAD score was associated with decreased performance in multiple cognitive domains (information processing speed, executive function, memory) and general cognitive performance across all participants. Brain-PAD score was not associated with age, duration of HIV infection, or other HIV-related measures. Conclusion: Increased apparent brain aging, predicted using neuroimaging, was observed in HIV-positive adults, despite effective viral suppression. Furthermore, the magnitude of increased apparent brain aging related to cognitive deficits. However, predicted brain age difference did not correlate with chronological age or duration of HIV infection, suggesting that HIV disease may accentuate rather than accelerate brain aging

A multi-data assessment of land use and land cover emissions from Brazil during 2000–2019

This is the final version. Available on open access from IOP Publishing via the DOI in this recordData availability statement: The data that support the findings of this study are available upon reasonable request from the authors.Brazil is currently the largest contributor of land use and land cover change (LULCC) carbon dioxide net emissions worldwide, representing 17%-29% of the global total. There is, however, a lack of agreement among different methodologies on the magnitude and trends in LULCC emissions and their geographic distribution. Here we perform an evaluation of LULCC datasets for Brazil, including those used in the annual global carbon budget (GCB), and national Brazilian assessments over the period 2000-2018. Results show that the latest global HYDE 3.3 LULCC dataset, based on new FAO inventory estimates and multi-annual ESA CCI satellite-based land cover maps, can represent the observed spatial variation in LULCC over the last decades, representing an improvement on the HYDE 3.2 data previously used in GCB. However, the magnitude of LULCC assessed with HYDE 3.3 is lower than estimates based on MapBiomas. We use HYDE 3.3 and MapBiomas as input to a global bookkeeping model (bookkeeping of land use emission, BLUE) and a process-based Dynamic Global Vegetation Model (JULES-ES) to determine Brazil's LULCC emissions over the period 2000-2019. Results show mean annual LULCC emissions of 0.1-0.4 PgC yr-1, compared with 0.1-0.24 PgC yr-1 reported by the Greenhouse Gas Emissions Estimation System of land use changes and forest sector (SEEG/LULUCF) and by FAO in its latest assessment of deforestation emissions in Brazil. Both JULES-ES and BLUE now simulate a slowdown in emissions after 2004 (-0.006 and -0.004 PgC yr-2 with HYDE 3.3, -0.014 and -0.016 PgC yr-2 with MapBiomas, respectively), in agreement with the Brazilian INPE-EM, global Houghton and Nassikas book-keeping models, FAO and as reported in the 4th national greenhouse gas inventories. The inclusion of Earth observation data has improved spatial representation of LULCC in HYDE and thus model capability to simulate Brazil's LULCC emissions. This will likely contribute to reduce uncertainty in global LULCC emissions, and thus better constrains GCB assessments

Localization and potential role of matrix metalloproteinase-1 and tissue inhibitors of metalloproteinase-1 and -2 in different phases of bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) can evolve in prematurely born infants who require mechanical ventilation because of hyaline membrane disease (HMD). The development of BPD can be divided in an acute, a regenerative, a transitional, and a chronic phase. During these different phases, extensive remodeling of the lung parenchyma with re-epithelialization of the alveoli and formation of fibrosis occurs. Matrix metalloproteinase-1 (MMP-1) is an enzyme that is involved in re-epithelialization processes, and dysregulation of MMP-1 activity contributes to fibrosis. Localization of MMP-1 and its inhibitors, tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2, were investigated in lung tissue obtained from infants who died during different phases of BPD development. In all studied cases (n = 50) type-II pneumocytes were found to be immunoreactive for MMP-1, TIMP-1, and TIMP-2. During the acute and regenerative phase of BPD, type-II pneumocytes re-epithelialize the injured alveoli. This may suggest that MMP-1 and its inhibitors, expressed by type-II pneumocytes, play a role in the re-epithelialization process after acute lung injury. Although MMP-1 staining intensity remained constant in type-II pneumocytes during BPD development, TIMP-1 increased during the chronic fibrotic phase. This relative elevation of TIMP-1 compared with MMP-1 is indicative for reduced collagenolytic activity by type-II pneumocytes in chronic BPD and may contribute to fibrosis. Fibrotic foci in chronic BPD contained fibroblasts immunoreactive for MMP-1 and TIMP-1 and -2. This may indicate that decreased collagen turnover by fibroblasts contributes to fibrosis in BPD development