Epidemiology, risk factors and strategies for the prevention of global unintentional fatal drowning in people aged 50 years and older: a systematic review

Purpose: Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people. Methods: A systematic literature review was undertaken using English-language, Portuguese-language and Spanish-language papers published between 1980 and 2015. The review explores gaps in the literature with a focus on the epidemiology, risk factors and strategies for the prevention of unintentional fatal drowning among people 50 years and over. Results: Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies; a lack of consensus on risk factors; a lack of total population, country-level analysis; and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated. Conclusion: This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies

Individual repeatability of avian migration phenology: a systematic review and meta-analysis

Changes in phenology and distribution are being widely reported for many migratory species in response to shifting environmental conditions. Understanding these changes and the situations in which they occur can be aided by understanding consistent individual differences in phenology and distribution and the situations in which consistency varies in strength or detectability. Studies tracking the same individuals over consecutive years are increasingly reporting migratory timings to be a repeatable trait, suggesting that flexible individual responses to environmental conditions may contribute little to population-level changes in phenology and distribution. However, how this varies across species and sexes, across the annual cycle and in relation to study (tracking method, study design) and/or ecosystem characteristics is not yet clear. Here, we take advantage of the growing number of publications in movement ecology to perform a phylogenetic multilevel meta-analysis of repeatability estimates for avian migratory timings to investigate these questions. Of 2,433 reviewed studies, 54 contained suitable information for meta-analysis, resulting in 177 effect sizes from 47 species. Individual repeatability of avian migratory timings averaged 0.414 (95% confidence interval: 0.3-0.5) across landbirds, waterbirds and seabirds, suggesting consistent individual differences in migratory timings is a common feature of migratory systems. Timing of departure from the non-breeding grounds was more repeatable than timings of arrival at or departure from breeding grounds, suggesting that conditions encountered on migratory journeys and outcome of breeding attempts can influence individual variation. Population-level shifts in phenology could arise through individual timings changing with environmental conditions and/or through shifts in the numbers of individuals with different timings. Our findings suggest that, in addition to identifying the conditions associated with individual variation in phenology, exploring the causes of between-individual variation will be key in predicting future rates and directions of changes in migratory timings. We therefore encourage researchers to report the within- and between- individual variance components underpinning the reported repeatability estimates to aid interpretation of migration behaviour. In addition, the lack of studies in the tropics means that levels of repeatability in less strongly seasonal environments are not yet clear

Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare

Background: Research has investigated whether communication technologies (e.g. mobile telephony, forums, email) can be used to transfer digital information between healthcare professionals and young people who live with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on communication. Methods: Nine electronic databases were searched. Technologies were described and a narrative synthesis of all studies was undertaken. Results: Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five categories of communication technologies were identified: video-and tele-conferencing (n = 2); mobile telephony (n = 3); telephone support (n = 3); novel electronic communication devices for transferring clinical information (n = 10); and web-based discussion boards (n = 1). Ten studies showed a positive improvement in HbA1c following the intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication technologies increased the frequency of contact between patient and healthcare professional. Findings were inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was available concerning behavioural and care coordination outcomes, although improvement in quality of life, patientcaregiver interaction, self-care and metabolic transmission were reported for some communication technologies. Conclusions: The breadth of study design and types of technologies reported make the magnitude of benefit and their effects on health difficult to determine. While communication technologies may increase the frequency of contact between patient and health care professional, it remains unclear whether this results in improved outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness and cost effectiveness of increasing the use of communication technologies between young people and healthcare professionals

The many positive impacts of participating in outreach activities on postgraduate students

Postgraduate students are excellent role models for school students, where their passion and energy play a vital role in engaging younger students and spreading enthusiasm and excitement about science. However, participating in outreach is not a one way activity for these postgraduate students. Through focus groups we show that the postgraduate students perceive that there are many benefits for themselves. These benefits are identified and discussed. This paper also contrasts the postgraduate with their undergraduate counterpart in terms of their contributions to engagement activities

A systematic review of adaptive wildlife management for the control of invasive, non-native mammals, and other human–wildlife conflicts

1.We are entering an era where species declines are occurring at their fastest ever rate, and the increased spread of non-native species is among the top causes. High uncertainty in biological processes makes the accurate prediction of the outcomes of management interventions very challenging. Adaptive management (AM) offers solutions to reduce uncertainty and improve predictability so that the outcomes of interventions can continuously improve. 2.We quantitatively assess the extent to which AM is used for managing vertebrates, with a focus on invasive non-native species (INNS). Using the Web of Science, we evaluated 3992 articles returned by the search terms ‘adaptive management’ or ‘adaptive harvest management’ against seven recommended elements of AM (engagement with stakeholders, defining objectives, forecasting and estimating uncertainty, implementing management, monitoring populations, adjusting management in response to monitoring, and improving forecasting and reducing uncertainty in response to monitoring populations). 3.The use of AM for vertebrates was reported in 56 (1%) of the evaluated studies; including four for managing INNS. Of these, ten studies excluding INNS and no studies of INNS management implemented all seven recommended elements of AM. Those elements infrequently implemented were: the use of analysis or models to forecast and represent uncertainty (44%) and the feedback of monitoring data to improve forecasting and reduce uncertainty (25%). 4.Complete active AM has rarely been implemented and reported for managing INNS, despite the significant advantages it offers. Among studies purporting to have implemented AM, most did not use analyses or models to forecast and represent uncertainty, while most defined objectives, implemented management, and monitored populations.5.Improvements to ongoing control programmes and much broader adoption of the AM approach are required to increase the efficiency and success of INNS management campaigns and reduce their negative impacts on native species

Individual consistency in migration strategies of a tropical seabird, the Round Island petrel

Background: In migratory species, the extent of within- and between-individual variation in migratory strategies can influence potential rates and directions of responses to environmental changes. Quantifying this variation requires tracking of many individuals on repeated migratory journeys. At temperate and higher latitudes, low levels of within-individual variation in migratory behaviours are common and may reflect repeated use of predictable resources in these seasonally-structured environments. However, variation in migratory behaviours in the tropics, where seasonal predictability of food resources can be weaker, remains largely unknown. Methods: Round Island petrels (Pterodroma sp.) are tropical, pelagic seabirds that breed all year round and perform long-distance migrations. Using multi-year geolocator tracking data from 62 individuals between 2009 and 2018, we quantify levels of within- and between-individual variation in non-breeding distributions and timings. Results: We found striking levels of between-individual variation in at-sea movements and timings, with non-breeding migrations to different areas occurring across much of the Indian Ocean and throughout the whole year. Despite this, repeat-tracking of individual petrels revealed remarkably high levels of spatial and temporal consistency in within-individual migratory behaviour, particularly for petrels that departed at similar times in different years and for those departing in the austral summer. However, while the same areas were used by individuals in different years, they were not necessarily used at the same times during the non-breeding period. Conclusions: Even in tropical systems with huge ranges of migratory routes and timings, our results suggest benefits of consistency in individual migratory behaviours. Identifying the factors that drive and maintain between-individual variation in migratory behaviour, and the consequences for breeding success and survival, will be key to understanding the consequences of environmental change across migratory ranges

Using technology to deliver cancer follow-up : a systematic review

Peer reviewedPublisher PD

Mapping the Distribution of Invasive Staphylococcus aureus across Europe

Franklin Lowy discusses a new study in PLoS Medicine in which the investigators developed an interactive tool for analyzing the spatial distribution of invasive Staphylococcus aureus

Associations of airway inflammation and responsiveness markers in non asthmatic subjects at start of apprenticeship

<p>Abstract</p> <p>Background</p> <p>Bronchial Hyperresponsiveness (BHR) is considered a hallmark of asthma. Other methods are helpful in epidemiological respiratory health studies including Fractional Exhaled Nitric Oxide (FENO) and Eosinophils Percentage (EP) in nasal lavage fluid measuring markers for airway inflammation along with the Forced Oscillatory Technique measuring Airway resistance (AR). Can their outcomes discriminate profiles of respiratory health in healthy subjects starting apprenticeship in occupations with a risk of asthma?</p> <p>Methods</p> <p>Rhinoconjunctivitis, asthma-like symptoms, FEV1 and AR post-Methacholine Bronchial Challenge (MBC) test results, FENO measurements and EP were all investigated in apprentice bakers, pastry-makers and hairdressers not suffering from asthma. Multiple Correspondence Analysis (MCA) was simultaneously conducted in relation to these groups and this generated a synthetic partition (EI). Associations between groups of subjects based on BHR and EI respectively, as well as risk factors, symptoms and investigations were also assessed.</p> <p>Results</p> <p>Among the 441 apprentice subjects, 45 (10%) declared rhinoconjunctivitis-like symptoms, 18 (4%) declared asthma-like symptoms and 26 (6%) suffered from BHR. The mean increase in AR post-MBC test was 21% (sd = 20.8%). The median of FENO values was 12.6 ppb (2.6-132 range). Twenty-six subjects (6.7%) had EP exceeding 14%. BHR was associated with atopy (p < 0.01) and highest FENO values (p = 0.09). EI identified 39 subjects with eosinophilic inflammation (highest values of FENO and eosinophils), which was associated with BHR and atopy.</p> <p>Conclusions</p> <p>Are any of the identified markers predictive of increased inflammatory responsiveness or of development of symptoms caused by occupational exposures? Analysis of population follow-up will attempt to answer this question.</p