Competing and conflicting messages via online news media: potential impacts of claims that the Great Barrier Reef is dying

Coverage of issues by news media is known to impact on both public perceptions and policy development aimed at addressing the featured issues. We examine the potential impact of news media coverage regarding the health and potential future of the World heritage-listed Great Barrier Reef, which is under multiple pressures, both natural and anthropogenic. We draw on the extant literature regarding the impact of news media coverage of other complex issues, linking to relevant, albeit limited theoretical concepts that have been applied to previous media studies. We find that media coverage is predominately sensationalized and negative, with the potential to reinforce perceptions that mitigation attempts will be ineffective and thus likely to inhibit future policy development. We discuss the need for a review of existing science communication models and strategies to reduce the knowledge-practice gap between scientists and policy makers, together with proactive strategies to counter negative news coverage

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Severe stridor and profound weakness after cerebral malaria.

Cerebral malaria (CM) is defined by WHO as coma (Blantyre Coma Score 2 or less) in a patient with Plasmodium falciparum parasitaemia and no alternative cause of coma identified. Mortality is approximately 15%-30% in African children and up to one-third of survivors have neurological sequelae. We present a patient with severe stridor and prolonged profound weakness during an intensive care admission with CM. These complications initially presented a diagnostic dilemma in our limited resourced setting. The stridor failed to improve with empiric steroids and a subsequent opportunistic ENT consult diagnosed vocal cord paresis. The weakness was so profound that the patient was unable to lift his head during the acute illness. The child received intensive physiotherapy, and at 1-month follow-up, the stridor and weakness had resolved

Structural interpretation of new high-resolution aeromagnetic and radiometric data over central Iran : Block definition and rotational tectonics

New high-resolution geophysical data over Central Iran defines > 30 continental fragments or blocks and lithotectonic domains, which are bounded by large-scale,kinematically-coherent structures that may be traced under significant cover. Normal, inverted normal and basin-bounding faults, and thrusts were transposed tosteeper dips with subsequent strike-slip movement. Assembly required three triangular“keystone blocks”, with edges defined by entrained ophiolites, which arerequired by rotational tectonics and the assembly of at least three adjacent blocks, in this instance combined with anticlockwise rotation of the Lut Block and CentralIranian Microcontinent. Late-kinematic, brittle-ductile to brittle, NNE-to NE-trending structures are superimposed on the macrostructural pattern. Fromc.12 Maonwards, NW-directed compressional tectonics resulted in the development of NNW-trending, dextral, strike-slip structures, notably the Dehshir Fault, whichoverlapped temporally with the main Cu-bearing, porphyry-forming event and Urumieh-Dokhtar Magmatic Arc development. The Shir-Kuh Block and fragmentsimmediately to the north of it originated approximately 200 km to the north, at the SW edge of the Anarak Metamorphic Complex. Southward movement of the Shir-Kuh Block was due to a combination of dextral movement along the Dehshir Fault and anticlockwise rotation of the Lut and Tabas Blocks. Major faults are delineatedin four separate basins: the Shotori Basin, the Kharanaq Basin, the Farrokhi Basin and the Gonabad Basin

Challenges of implementing the Paediatric Surviving Sepsis Campaign International Guidelines 2020 in resource-limited settings: A real-world view beyond the academia.

The Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-associated Organ Dysfunction in Children was released in 2020 and is intended for use in all global settings that care for children with sepsis. However, practitioners managing children with sep sis in resource-limited settings (RLS) face several challenges and disease patterns not experienced by those in resource-rich settings. Based upon our collective experience from RLS, we aimed to reflect on the difficulties of implementing the international guidelines. We believe there is an urgent need for more evidence from RLS on feasible, efficacious approaches to the management of sepsis and septic shock that could be included in future context-specific guidelines

Urban Growth Boundaries and their impact on land prices

Undeveloped land transactions at the urban fringe of the Melbourne metropolitan area in Australia are recorded in a dataset that enables exploration of the impact of its urban growth boundary (UGB) on residential land prices. Estimation can take account of a wide range of factors, while controlling for policy anticipation effects and other potential influences on land prices. Modelling estimates indicate that land prices rose substantially inside the UGB after its enactment in 2003, but did not rise much outside of it. These results suggest that the urban growth boundary has had a significant upward effect on the trajectory of the urban region’s house prices. Keywords: urban growth boundary, land prices, land market dynamic