Climate change and water-related infectious diseases

Background: Water-related, including waterborne, diseases remain important sources of morbidity and mortality worldwide, but particularly in developing countries. The potential for changes in disease associated with predicted anthropogenic climate changes make water-related diseases a target for prevention. Methods: We provide an overview of evidence on potential future changes in water-related disease associated with climate change. Results: A number of pathogens are likely to present risks to public health, including cholera, typhoid, dysentery, leptospirosis, diarrhoeal diseases and harmful algal blooms (HABS). The risks are greatest where the climate effects drive population movements, conflict and disruption, and where drinking water supply infrastructure is poor. The quality of evidence for water-related disease has been documented. Conclusions: We highlight the need to maintain and develop timely surveillance and rapid epidemiological responses to outbreaks and emergence of new waterborne pathogens in all countries. While the main burden of waterborne diseases is in developing countries, there needs to be both technical and financial mechanisms to ensure adequate quantities of good quality water, sewage disposal and hygiene for all. This will be essential in preventing excess morbidity and mortality in areas that will suffer from substantial changes in climate in the future

Exercise and pregnancy: information for practice nurses

It has long been recognised that regular physical activity and exercise enhance both physical and psychological wellbeing. The benefits of physical activity throughout the lifespan of an individual cannot be underestimated and it is no less important when a woman is planning to become pregnant or is pregnant. The World Health Organisation (WHO) (2010) note that physical inactivity is the fourth leading risk factors for global mortality and is attributed to 6% of deaths globally. This article explores the guidance for physical activity for the general population and how it then relates to the guidance available for women who are pregnant. This article considers some of the key benefits to a range of common physical activities that pregnant women may undertake. It also explores some of the information that practice nurses should be aware of and how physical activity may impact on several long-term health conditions such as asthma, diabetes and obesity. Key points • Physical activity at any stage of the lifespan should be encouraged but physical activity in pregnancy is important for a variety of maternal and fetal health benefits • Practice nurses should be aware of the long-term health benefits of physical activity, be able to discuss these with patients and signpost them to useful resources • Practice nurses should be aware of any contraindications to physical activity in pregnancy • Practice nurses play a vital role in the monitoring and surveillance of some life-long health conditions that also affect pregnant wome

Humanising relational knowing: an appreciative action research study on relationship-centred practice on stroke units.

Over the past two decades, NHS stroke services in England have improved the organisation of hospital-based stroke care, leading to improved outcomes after a stroke. However, this drive for improvement has not always been informed by a holistic view of stroke recovery and rehabilitation. Stroke survivors and their carers ask for individualised, person-centred care, with less focus on the physical aspects of their recovery (Stroke Association 2013; Luker et al. 2015). Despite a plethora of national recommendations on person-centred care, there is little actual ‘know how’ on achieving this within stroke services. An appreciative action research (AAR) method was used to develop a relationship- centred care (RCC) approach within a stroke unit setting. It was a two-phase study conducted on two combined acute and rehabilitation stroke units in the south west of England over 20 months. The first phase objectives were to explore and describe participants’ meaningful relational experiences and the processes that supported them. The objective of phase two was to take the processes learnt from phase one and explore whether these could be translated to a second stroke unit. Data were generated from 17 interviews, 400 hours of observations, 10 staff discussion groups, and the researcher’s reflective diary. Initial co-analysis using sense-making with participants was part of the AAR process, with this analysis informing the subsequent phases of the AAR cycles (Cooperrider et al. 2005). Further in-depth analysis was conducted using immersion crystallisation to confirm and broaden the original themes (Borkan 1999). Data analysis was informed by relational constructionist and humanising/lifeworld-led care perspectives (McNamee and Hosking 2012, Galvin & Todres 2013). Data described that participants (patients, relatives and staff) all valued similar relational experiences around human connections to support existential well-being. The AAR process supported changes in self, and the culture on the stroke units, towards an increased value placed on human relationships, including colleague relationships among staff. The processes that supported human connections in practice included: i. sensitising to humanising relational knowing through appreciative noticing; ii. reflecting and sharing these experiences with others to co-create a relational discourse; iii. having the freedom to act, enabling human connections. Developing processes to support humanising relational knowing revealed the complex, experiential and constantly changing nature of this way of knowing. Open reflective and reflexive spaces, created by animation and facilitation, were important to support staff to maintain sensitivity towards relational knowing within an acute care context. The outcomes from this study build on existing humanising/lifeworld-led care theories through: developing orientations for practice that support relational knowing, and; proposing development of the RCC model to include humanising values of embodiment, insiderness and agency

Low-Consumption Partial Transcoding by HEVC

A transcoding scheme for the High Efficiency Video Coding (HEVC) is proposed that allows any partial frame modification to be followed by a partial re-compression of only the modified areas, while guaranteeing identical reconstruction of non-modified areas. To this end, first, syntax elements of all Coding Units (CU) in the frame are parsed and decoded according to their scan order. Then CUs that are collocated with a replaced area are re-encoded with new content to generate a partial set of new syntax elements. In order to avoid spatial propagation of the decoding mismatch due to the new content, CUs on the border of the replaced area are losslessly coded such that reconstruction of immediately neighboring CUs in the scan order are protected from the modification. The proposed method has been implemented on top of the HEVC test Model (HM) in All-Intra (AI) coding configuration and experiments show that, depending on the test parameters, it can offer both a bitrate saving (up to 4% in terms of BD-BR) and a transcoding acceleration (up to 83%) compared to a full transcoding scheme

Changing patterns in global blindness: 1988–2008

When the Community Eye Health Journal was launched in 1988, the world population was approximately 5.1 billion. Over the last 20 years, it has increased by approximately 30%, reaching 6.7 billion in 2008. During the same period, the world population has also become proportionally older, as the number of people aged 65 years and over has increased by approximately 55%, from 320 million in 1988 to 500 million in 2008. Since the prevalence of visual impairment becomes higher as people age, this combination of an increasing population and an ageing population is expected to cause a significant increase in the total number of blind people

After the Rain – learning the lessons from flood recovery in Hull

The report shows that it is often not so much the floods themselves, but what comes afterwards, that people find so difficult to deal with. The research on which this report is based aimed to undertake a real-time longitudinal study to document and understand the everyday experiences of individuals following the floods of June 2007 in interaction with networks of actors and organisations, strategies of institutional support and investment in the built environment and infrastructure. It had the following objectives: - To identify and document key dimensions of the longer term experience of flood impact and flood recovery, including health, economic and social aspects. - To examine how resilience and vulnerability were manifest in the interaction between everyday strategies of adaptation during the flood recovery process, and modes of institutional support and the management of infrastructure and the built environment. -To explore to what extent the recovery process entailed the development of new forms of resilience and to identify the implications for developing local level resilience for flood recovery in the future. To develop an archive that will be accessible for future research into other aspects of flood recovery. The flooding which affected the city of Kingston-upon-Hull took place in June 2007. Over 110mm of rain fell during the biggest event, overwhelming the city‟s drainage system and resulting in widespread pluvial flooding. The floods affected over 8,600 households and one person was killed. Our research used in-depth, qualitative methods where 44 people kept weekly diaries and participated in interviews and group discussions over an 18-month period

Outside the Military “Bubble”: Life After Service for UK Ex-armed Forces Personnel

Military personnel who have seen active service can be affected by their experiences. Much of the literature on the mental and physical health battles faced by men and women who leave the Armed Forces is dominated by research in the United States (US) (1), and is particularly focused on exposure to deployment, combat conditions, and effects on mental health. Research in the United Kingdom (UK) tends to focus on depression or alcohol misuse and the impact these issues have on currently serving personnel. This study aimed to present UK veterans' first-hand experiences related to military service, access to and use of mental healthcare and interventions, and the impact of transition on the military family. Semi-structured interviews explored experiences of 30 participants (27 male, 3 female). Participants ranged in age from 26 to 92 years (M = 53.33), and across multiple war cohorts (from WWII to Iraq and Afghanistan). Data were analyzed using Thematic Analysis and Narrative Analysis. Findings show meaning-making from experiences of transition across veteran cohorts. Main themes were reasons for leaving Armed Forces, life outside the military, and mental health concerns after service. Subordinate themes additionally focused on evaluation of identity and mental health service provision. Future clinical research should include the experiences of UK serving personnel and the effects of pre-and post-military adversity, alongside the impact of deployment experiences. Interventions designed to address transition into life after service are discussed

COOL-CHIC: Coordinate-based Low Complexity Hierarchical Image Codec

We introduce COOL-CHIC, a Coordinate-based Low Complexity Hierarchical Image Codec. It is a learned alternative to autoencoders with approximately 2000 parameters and 2500 multiplications per decoded pixel. Despite its low complexity, COOL-CHIC offers compression performance close to modern conventional MPEG codecs such as HEVC and VVC. This method is inspired by the Coordinate-based Neural Representation, where an image is represented as a learned function which maps pixel coordinates to RGB values. The parameters of the mapping function are then sent using entropy coding. At the receiver side, the compressed image is obtained by evaluating the mapping function for all pixel coordinates. COOL-CHIC implementation is made available upon request