Modelling the effect of temperature on the seasonal population dynamics of temperate mosquitoes

Mosquito-borne diseases cause substantial mortality and morbidity worldwide. These impacts are widely predicted to increase as temperatures warm and extreme precipitation events become more frequent, since mosquito biology and disease ecology are strongly linked to environmental conditions. However, direct evidence linking environmental change to changes in mosquito-borne disease is rare, and the ecological mechanisms that may underpin such changes are poorly understood. Environmental drivers, such as temperature, can have non-linear, opposing impacts on the demographic rates of different mosquito life cycle stages. As such, model frameworks that can deal with fluctuations in temperature explicitly are required to predict seasonal mosquito abundance, on which the intensity and persistence of disease transmission under different environmental scenarios depends. We present a novel, temperature-dependent, delay-differential equation model, which incorporates diapause and the differential effects of temperature on the duration and mortality of each life stage and demonstrates the sensitivity of seasonal abundance patterns to inter- and intra-annual changes in temperature. Likely changes in seasonal abundance and exposure to mosquitoes under projected changes in UK temperatures are presented, showing an increase in peak vector abundance with warming that potentially increases the risk of disease outbreaks

Enhancing Communication about Paediatric Medicines: Lessons from a Qualitative Study of Parents' Experiences of Their Child's Suspected Adverse Drug Reaction

Background: There is little research on parents’ experiences of suspected adverse drug reactions in their children and hence little evidence to guide clinicians when communicating with families about problems associated with medicines. Objective: To identify any unmet information and communication needs described by parents whose child had a suspected adverse drug reaction. Methods: Semi-structured qualitative interviews with parents of 44 children who had a suspected adverse drug reaction identified on hospital admission, during in-patient treatment or reported by parents using the Yellow Card Scheme (the UK system for collecting spontaneous reports of adverse drug reactions). Interviews were conducted face-to-face or by telephone; most interviews were audiorecorded and transcribed. Analysis was informed by the principles of the constant comparative method. Results: Many parents described being dissatisfied with how clinicians communicated about adverse drug reactions and unclear about the implications for their child’s future use of medicines. A few parents felt that clinicians had abandoned their child and reported refusing the use of further medicines because they feared a repeated adverse drug reaction. The accounts of parents of children with cancer were different. They emphasised their confidence in clinicians’ management of adverse drug reactions and described how clinicians prospectively explained the risks associated with medicines. Parents linked symptoms to medicines in ways that resembled the established reasoning that clinicians use to evaluate the possibility that a medicine has caused an adverse drug reaction. Conclusion: Clinicians’ communication about adverse drug reactions was poor from the perspective of parents, indicating that improvements are needed. The accounts of parents of children with cancer indicate that prospective explanation about adverse drug reactions at the time of prescription can be effective. Convergence between parents and clinicians in their reasoning for linking children’s symptoms to medicines could be a starting point for improved communication

Damage evaluation during installation of geosynthetics used in asphalt pavements

Geosynthetics are commonly used as anti-reflective cracking systems in asphalt pavements. The rehabilitation design methods use the characteristics of as-received geosynthetics as inputs. However, these materials undergo physical damage during their installation due to mechanical and thermal loads which currently are not taken into account in the design processes. These loads can produce a reduction in geosynthetic strength and therefore, it is necessary to know the secant modulus after installation in order to improve the pavement design incorporating these materials. The secant modulus of a material indicates its initial stiffness. This paper describes an experimental study of damage due to installation of five different geosynthetics using three different procedures: (i) mechanical damage induced in the laboratory considering the action of aggregates, (ii) in situ mechanical and thermal damage due to actual installation in a test section, and (iii) a new mechanical and thermal damage experimental test developed with the aim of reproducing the real installation conditions. The main results of the study indicate that the obtained secant modulus of the tested geosynthetics reduced after applying the three damage procedures, and the loss of properties differed depending on the type and constitutive material and on the applied damage procedure.This investigation was supported by the research Project ‘Rehabilitation of roads and highways (REHABCAR)’ file number IPT-370000–2010–029, led by DRAGADOS (ACS Group), in collaboration with GEOCISA and ASFALTOS AUGUSTA among others. The project has been funded by the Ministry of Economy and Competitiveness (MINECO) within the National Plan for Scientific Research, Development and Innovation 2008–2011 (INNPACTO 2010) and the European Union under ERDF Funds (European Regional Development Fund)

Twenty years of global surveillance of antituberculosis-drug resistance

Antimicrobial resistance represents a major threat to global health and security. In 2014, the World Health Assembly called on all nations and the international community to take every necessary measure to control it, including surveillance of its emergence and spread.1 The development of drug resistance in Mycobacterium tuberculosis was first documented in the late 1940s, soon after antibiotic therapy was introduced for tuberculosis treatment.2 It quickly became obvious that combination chemotherapy could prevent the emergence of drug resistance3 and that patients infected with drug-resistant strains were less likely to be cured.4 Nevertheless, it was only in the early 1990s that drugresistant tuberculosis began to receive global attention as a public health threat. This coincided with the detection of outbreaks of multidrugresistant (MDR) tuberculosis (defined as resistance to at least rifampin and isoniazid) that were associated with high mortality among patients coinfected with the human immunodeficiency virus (HIV).5-8 The urgent need for a global mechanism to monitor the emergence and spread of resistance to antituberculosis drugs became clear. In 1994, the Global Tuberculosis Program of the World Health Organization (WHO), with the support of the International Union against Tuberculosis and Lung Disease (the Union), established the Global Project on Anti-Tuberculosis Drug Resistance Surveillance (hereafter referred to as \u201cthe project\u201d) to measure the magnitude of drug resistance and to monitor trends. This project remains the oldest and largest initiative on the surveillance of antimicrobial resistance in the world.9 In this article, we describe the history of global surveillance of drug resistance in tuberculosis and discuss methods for surveillance, the quality of available data, the key achievements and findings to date, the main challenges that remain, and future directions

The Lunar Geophysical Network Mission

The National Academy’s current Planetary Decadal Survey (NRC, 2011) prioritizes a future Lunar Geophysical Network (LGN) mission to gather new information that will permit us to better determine how the overall composition and structure of the Moon inform us about the initial differentiation and subsequent evolution of terrestrial planets

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy