Human activities link fruit bat presence to Ebola virus disease outbreaks

1. A significant link between forest loss and fragmentation and human outbreaks of Ebola virus disease (EVD) has been documented. Deforestation may alter the natural circulation of viruses as well as change the composition, abundance, behaviour and possibly viral exposure of reservoir species. This in turn might increase contact between infected animals and humans. Fruit bats of the family Pteropodidae have been suspected as reservoirs of the Ebola virus. Though there is no solid proof that fruit bats cause human EVD outbreaks, this group of animals have been intermittently infected with the Ebola virus. 2. Our study investigates whether human activities positively affect African fruit bat species’ ranges and whether their ranges are linked to EVD outbreaks, in turn favoured by deforestation. 3. We use species observation records for the 20 fruit bat species found in Africa to determine factors affecting their distribution in two geographical scenarios: 1) the African continent; and 2) inside the predicted Ebola virus range. We do this by employing a hypothetico-deductive approach based on favourability modelling. 4. Our models point to clear associations between human activities and fruit bat distributions that may help scientists understand the anthropogenic settings that could cause the Ebola virus to jump from animals to humans. 5. We show that fruit bat distributions are linked to human activities throughout Africa and particularly within the region where the Ebola virus occurs. More specifically, the areas where human activities favour the presence of five fruit bat species (four of which had recorded seropositive individuals) overlap with EVD outbreak areas, themselves favoured by deforestation. 6. Our work is a useful first step to further investigate the networks and pathways that may lead to an EVD outbreak. The modelling framework we employ here can be employed for other emerging infectious diseases

La biographie du compositeur Corneille Verdonck (1563-1625), etude critique

n/

IPS in supported housing:Fidelity and employment outcomes over a 4 year period

Background: People with severe mental illness have difficulties finding and maintaining competitive employment. This is particularly so for those living in supported housing who, by definition, have significant day-to-day support needs: in the Netherlands only 3 to 5% of people with serious mental health problems who live in supported housing are competitively employed. To support these people in finding and maintaining competitive employment, Individual Placement, and Support (IPS) was introduced within supported housing services in the Netherlands in 2015. As this is the first country that broadly implemented IPS in supported housing settings, this paper will focus on the first results regarding feasibility and effects on employment in clients of IPS in this sector. Methods: We investigated the feasibility and employment outcomes of delivering IPS in supported housing services using fidelity assessments and quarterly employment outcomes on IPS program level within eight supported housing organizations, and compared these with 21 mental health treatment organizations in the Netherlands over a 4 year period. We investigated possible reasons for our findings and their implications through qualitative evaluations of the IPS fidelity assessors' notes and additional focus groups with IPS specialists and coordinators from supported housing services and fidelity assessors. Results: The overall fidelity scores indicated reasonable implementation of the IPS model within both supported housing services and mental health services. However, there were differences between services with regard to specific fidelity items; mental health treatment organizations scored higher for team integration, whereas supported housing services scored higher for rapid job search and caseload size, diversity of jobs, and employers. Our qualitative data suggested that the difference in team integration between the two sectors was due to differences in their organizational and financial structures, as well as in the specific needs of their clients. Conversely, supported housing services had better connections with employers which facilitated more rapid job searching and greater diversity in employment opportunities. The average total client employment rate did not significantly differ; and was 25.8% per quarter in supported housing services and 29.6% in mental health treatment services. Conclusion: Implementing IPS in supported housing settings is both feasible and effective

High levels of women's satisfaction and compliance with transdermal contraception: results from a European multinational, 6-month study

Objective. To investigate compliance, satisfaction, and preference in women using a transdermal contraceptive patch. Methods. Women (18–46 years) from eight European countries used contraceptive patches (norelgestromin 6 mg, ethinylestradiol 600 mg) for six, 4-week treatment cycles. Compliance, satisfaction, and preference were assessed after 3 and 6 cycles and study completion using self-report methods. Results. Of the 778 participants, 36.8 % (n 287) used no contraception at baseline. The most common methods were oral contraceptives (67.9%, n 334) and barrier methods (21.5%, n 106). Of oral contraception users, 63.5 % (n 212) were satisfied or very satisfied with their previous method, but compliance was poor with 77.8 % (n 260) reporting missed doses. After 3 and 6 cycles,480 % of all included women were satisfied or very satisfied with the patch. At study completion, most participants (73.7%) reported a preference for the patch compared to their previous method. Of 4107 cycles, 3718 (90.5%) were completed with perfect compliance. Two pregnancies occurred during this study, representing a Pearl Index of 0.63. No new safety issues were identified and the patch was well tolerated. Conclusion. Women were highly satisfied with transdermal contraception and preferred this form of family planning over their previous method. Transdermal contraception represents a valuable addition to contraceptive options with potential t

Protocol of the SOMNIA project : an observational study to create a neurophysiological database for advanced clinical sleep monitoring

Introduction Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods. Methods and analysis We aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm