Tsetse, trypanosomiasis and cattle in a changing environment

Identifies interrelationships between modifications of the environment and the growth of Nigeria's population and consequent agricultural expansion in the subhumid zone resulting in the disappearance of habitats & hosts of tsetse. Discusses impacts of these changes in the distribution of the national cattle herd, particularly in relation to incidence of tsetse & trypanosomiasis

Mapping disease data: A usability test of an internet based system of disease status disclosure

Disease maps are important tools in the management of disease. By communicating risk, disease maps can help raise awareness of disease and encourage farmers and veterinarians to employ best practice to eliminate the spread of disease. However, despite the importance of disease maps in communicating risk and the existence of various online disease maps, there are few studies that explicitly examine their usability. Where disease maps are complicated to use, it seems that they are unlikely to be used effectively. The paper outlines an attempt to create an open access, online, searchable map of incidents of bovine tuberculosis in England and Wales, and analyzes its usability among veterinarians. The paper describes the process of creating the map before describing the results of a series of usability trials. Results show the map to score highly on different measures of usability. However, the trials also revealed a number of social and technical limitations and challenges facing the use of online disease maps, including reputational dangers, role confusion, data accuracy, and data representation. The paper considers the challenges facing disease maps and their potential role in designing new methodologies to evaluate the effectiveness of disease prevention initiatives

Global data for ecology and epidemiology: a novel algorithm for temporal Fourier processing MODIS data

Background. Remotely-sensed environmental data from earth-orbiting satellites are increasingly used to model the distribution and abundance of both plant and animal species, especially those of economic or conservation importance. Time series of data from the MODerate-resolution Imaging Spectroradiometer (MODIS) sensors on-board NASA's Terra and Aqua satellites offer the potential to capture environmental thermal and vegetation seasonality, through temporal Fourier analysis, more accurately than was previously possible using the NOAA Advanced Very High Resolution Radiometer (AVHRR) sensor data. MODIS data are composited over 8- or 16-day time intervals that pose unique problems for temporal Fourier analysis. Applying standard techniques to MODIS data can introduce errors of up to 30% in the estimation of the amplitudes and phases of the Fourier harmonics. Methodology/Principal Findings. We present a novel spline-based algorithm that overcomes the processing problems of composited MODIS data. The algorithm is tested on artificial data generated using randomly selected values of both amplitudes and phases, and provides an accurate estimate of the input variables under all conditions. The algorithm was then applied to produce layers that capture the seasonality in MODIS data for the period from 2001 to 2005. Conclusions/Significance. Global temporal Fourier processed images of 1 km MODIS data for Middle Infrared Reflectance, day- and night-time Land Surface Temperature (LST), Normalised Difference Vegetation Index (NDVI), and Enhanced Vegetation Index (EVI) are presented for ecological and epidemiological applications. The finer spatial and temporal resolution, combined with the greater geolocational and spectral accuracy of the MODIS instruments, compared with previous multi-temporal data sets, mean that these data may be used with greater confidence in species' distribution modelling

High habitat richness limits the risk of tick-borne encephalitis in Europe: a multi-scale study

The natural transmission cycle of tick-borne encephalitis (TBE) virus is enhanced by complex interactions between ticks and key hosts strongly connected to habitat characteristics. The diversity of wildlife host species and their relative abundance is known to affect transmission of tick-borne diseases (such as, for example, Lyme disease). In the current context of global biodiversity loss, we explored the relationship between the habitat richness index (HRI) and the pattern of human TBE cases in Europe to assess the role of HRI in disease risk mitigation. Methods: We assessed human TBE case distribution across 879 European regions using official epidemiological data reported to the European Surveillance System (TESSy) between 2017 and 2021 from 15 countries. We statistically explored the relationship between TBE presence and a novel variable - the habitat richness index (HRI) - describing the diversity of European ecosystem types. We also validated our findings at local scale using data collected between 2017 and 2021 in 227 municipalities located in Trento and Belluno provinces, two known TBE foci in northern Italy. Findings: Our results showed a significant parabolic effect of HRI on the probability of presence of human TBE cases in the European regions included in our dataset, and a significant, negative effect of HRI on the local presence of TBE in northern Italy. At both spatial scales, TBE risk decreases in areas with higher values of HRI. Interpretation: To our knowledge, no efforts have yet been made to explore the relationship between habitat richness and TBE risk, both in local and in large scale geographical contexts, probably due to the scarcity of high-resolution, large-scale data about the abundance or density of critical host species, such as rodents and ungulates. To overcome this lack o f data, in this study we considered habitat richness as proxy of vertebrate host biodiversity to disentangle its role in driving TBE European occurrence at different spatial scales. The results suggest that biodiversity loss could considerably enhance disease risk for both humans and wildlife, which may influence biodiversity conservation policies within a One Health context approach

Behavioral health emergencies encountered by community paramedics: lessons from the field and opportunities for skills advancement

INTRODUCTION: When an individual calls 911 because of a behavioral health emergency, paramedics may be the first health care professional on scene to address that crisis. Traditionally, the paramedic profession has been educated to respond to life-threatening medical emergencies.1 Paramedics are increasingly expected to respond to behavioral health crises but may not be adequately prepared to do so. 1 There has been limited research regarding paramedics’ experiences, attitudes, and perceptions about responding to behavioral health crises, with a particular dearth of literature on this subject from the USA. 1,2,3,4,5 As the first point of contact, paramedics may influence the quality of care individuals experiencing behavioral health emergencies receive, rendering this gap in knowledge concerning. 1,4 Paramedics encounter a range of behavioral health crises, from individuals who have self-harmed, substance use, to older adults experiencing social isolation. 6,7 This study aimed to answer the following questions: Do paramedics feel well prepared to respond to behavioral health crises? How do paramedics describe the challenges and facilitators involved in responding to these situations? What are the skills they use to respond to these situations? The present study examined paramedics’ experiences and perceptions regarding behavioral health emergencies, aiming to address a significant gap in the literature on paramedics’ ability to respond to the needs of individuals experiencing behavioral health crises. BACKGROUND: Limited research based in the UK, Europe, and Australia has examined the extent to which paramedics feel equipped by their training to respond to situations of a behavioral health nature, with a marked lack of USA-based research in this area. In a survey of members of the College of Paramedics (UK), 98% of the 623 respondents endorsed the need for increased mental health education and training. 2 Paramedic training curriculums in the UK have evolved to incorporate more of an emphasis on behavioral health, yet whether or not this behavioral health training is effective has not yet been investigated. 1 Several Australian studies investigated paramedic perceptions of their mental health training and decision-making during mental health emergencies.5,8. Paramedic participants reported inadequate mental health training and indicated a need for increased education on mental illness, particularly regarding possible treatment options that are feasible as part of prehospital care.8. Paramedics described relying more on intuition than education when faced with challenging cases.5 In a mixed methods study, Australian paramedics reported the need for more education on how to adequately respond to older adults experiencing complex mental health crises including depression, social isolation, and food insecurity.7 Limited research has explored paramedic perceptions, attitudes, and experiences responding to behavioral health emergencies, but the existing research indicates that many emergency healthcare providers consider physical health emergencies more valuable or important than behavioral health emergencies.8,9,10 Studies indicate that paramedic students do not consider training in mental health issues as relevant to the profession,1 with an Australian study of paramedic undergraduate students indicating a lower level of regard for those with intellectual disabilities, substance abuse disorders, or acute mental illness compared to students studying in other health professions.11 A multi-site, qualitative study based in Paris, France and New York, New York examined how social and professional values influenced prehospital emergency workers’ responses.9 The authors found that patients deemed to have lower social value were lower priority to emergency providers, with cases involving substance use or calls from lower socioeconomic areas, for instance, regarded as less legitimate uses of emergency services.9 Notably, situations that required more complex or heroic medical or surgical actions were also attributed higher value by emergency healthcare workers.9 Greater importance was attributed to medical (versus behavioral health) emergencies across additional studies, with paramedic participants implying that behavioral health calls were not valid emergencies,5 and with paramedic participants indicating that their role is mainly to transport—not to treat—individuals experiencing behavioral health crises.8 Additionally, paramedic participants perceived their services as often used inappropriately for behavioral health emergencies due to the limited availability of more appropriate behavioral health services.8 Related research regarding the perceptions of emergency department physicians and nurses in the USA also revealed a greater value placed on physical versus behavioral health emergencies, as well as perceptions that certain crises (such as self-harm) were less valid, or less worthy of emergency treatment.10 This is particularly concerning given that emergency department healthcare providers interact with a substantial number of persons seeking behavioral health emergency care: in 2015, approximately 4.1% of visits to an emergency department were related to diagnosed mental health disorders (approximately 5,666,000 visits).12 The number of emergency department visits related to opioid overdose increased by 29.7% in the USA between July 2016 and September 2017.13 Emergency healthcare workers are treating a significant number of behavioral health emergencies, rendering improved understanding of healthcare providers’ perceptions and attitudes towards this population crucial. Existing research into the perceptions of experienced paramedic practitioners regarding behavioral health emergencies is limited.1,3,4 With the exception of a multi-site study based in New York, New York and Paris, France,9 a thorough review of the extant literature failed to unearth research on the perceptions and experiences of paramedics responding to behavioral health crises in the USA. This is a particularly significant gap, as differences in paramedic education, relevant behavioral health legislation, and culture may exist across countries. The present study used qualitative analyses of in-depth interviews of practicing paramedics to address this gap by examining paramedics’ perceptions and experiences responding to behavioral health crises in the USA. METHODS: This study was part of a Patient-Centered Outcomes Research Institute (PCORI) contract funding an examination of the Acute Community Care Program (ACCP) at Commonwealth Care Alliance (CCA). The Acute Community Care Program is a state-funded community paramedicine intervention for the patients of CCA, in conjunction with EasCare Ambulance Company. INTERVIEW GUIDE AND RECRUITMENT: The research team, which included experienced paramedics at EasCare Ambulance Company, worked together to create an open-ended guide to interview paramedics. The interview protocol consisted of six sections: (1) history of career as paramedic, (2) current skills and job experiences, (3) views of paramedic experience, (4) career goals, (5) final questions and wrap up, and (6) demographics. The research team revised the original guide after several pilot interviews and based on feedback from key informants, namely seasoned paramedic supervisors from the research team. Interviews with paramedics lasted approximately 1 h and were conducted over the phone by either the PI or Co-PI, who are experienced in qualitative research. The research team intended to interview 25 paramedics who would be identified through two large ambulance companies in the Greater Boston area of Massachusetts. The director at these ambulance companies asked their paramedics on staff if they would be willing to be interviewed and, if they agreed, the director gave us their contact information. Six paramedics who had initially agreed could not be reached, and arrangements were made with one paramedic who did not follow through with the interview. In total, the researchers conducted telephone interviews with 23 paramedics, after receiving verbal informed consent to perform and record the interview. Participants were mailed a $50 gift card to thank them for their time. Professional transcription service transcribed digital recordings verbatim, and the project manager reviewed all transcripts against the digital recording, making small corrections as needed. DATA ANALYSIS: Audiotapes of the sessions were analyzed by three research team members. A thematic analysis approach was utilized, starting with familiarization with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing a final analysis.14 The researchers worked both separately and collaboratively, working individually at each stage of the process and then coming together to compare results in order to ensure the validity of identified themes. Early readings of the transcript data allowed the researchers to develop preliminary ideas regarding potential themes. Each researcher then thoroughly analyzed the individual transcripts, generating initial codes and beginning to search for themes both within and across documents. During this stage, the researchers met frequently to compare and contrast the results of each individual’s analysis, reviewing emerging themes and collaborating to refine themes into a coherent set. To asses inter-rater reliability, two un-read transcripts were reviewed by all team members and coded independently, followed by meetings as a research team to compare coding decisions on each transcript and reconcile any discrepancies. This rigorous process helped to ensure strong inter-rater reliability as we were able to gain consensus in our coding process for all other transcripts. Researchers individually arranged transcript data verbatim into groups of initial themes, and a master document was then created collaboratively, which outlined each finalized theme and included transcript excerpts embodying each theme. Memo-writing was employed throughout the analytic process to document coding decisions.15 As a final check for validity, the two experienced paramedic supervisors from the research team reviewed the themes and subthemes and provided feedback about the findings. The paramedic supervisors confirmed that these themes were what they might have expected the data to reveal, further validating the findings. RESULTS: Table 1 shows demographic characteristics of the 23 participants. Results for this paper will focus on three themes identified in the data analysis. Namely, paramedics (1) report frequently working with patients who are having a behavioral health crisis, (2) report having inadequate behavioral health training, and (3) have many difficulties managing these patients, relying primarily on their professional experiences and/or strong interpersonal skills rather than explicit training to address patients’ needs (see Table 2).Accepted manuscrip

Farming on the edge: farmer attitudes to bovine tuberculosis in newly endemic areas

Defra's recent strategy to eradicate bovine tuberculosis (bTB) establishes three spatial zones: high-risk areas (HRAs) and low-risk areas, and an area referred to as ‘the edge’, which marks the areas where infection is spreading outwards from the HRA. Little is known about farmers in the edge area, their attitudes towards bTB and their farming practices. This paper examines farmers’ practices and attitudes towards bTB in standardised epidemiologically defined areas. A survey was developed to collect data on farmer attitudes, behaviours, practices and environmental conditions as part of an interdisciplinary analysis of bTB risk factors. Survey items were developed from a literature review and focus groups with vets and farmers in different locations within the edge area. A case-control sampling framework was adopted with farms sampled from areas identified as recently endemic for bTB. 347 farmers participated in the survey including 117 with bTB, representing a 70 percent response rate. Results show that farmers believe they are unable to do anything about bTB but are keen for the government intervention to help control the spread of bTB