Sustained type 1 diabetes self-management: Specifying the behaviours involved and their influences.

AIMS: Sustained engagement in type 1 diabetes self-management behaviours is a critical element in achieving improvements in glycated haemoglobin (HbA1c) and minimising risk of complications. Evaluations of self-management programmes, such as Dose Adjustment for Normal Eating (DAFNE), typically find that initial improvements are rarely sustained beyond 12 months. This study identified behaviours involved in sustained type 1 diabetes self-management, their influences and relationships to each other. METHODS: A mixed-methods study was conducted following the first two steps of the Behaviour Change Wheel framework. First, an expert stakeholder consultation identified behaviours involved in self-management of type 1 diabetes. Second, three evidence sources (systematic review, healthcare provider-generated 'red flags' and participant-generated 'frequently asked questions') were analysed to identify and synthesise modifiable barriers and enablers to sustained self-management. These were characterised according to the Capability-Opportunity-Motivation-Behaviour (COM-B) model. RESULTS: 150 distinct behaviours were identified and organised into three self-regulatory behavioural cycles, reflecting different temporal and situational aspects of diabetes self-management: Routine (e.g. checking blood glucose), Reactive (e.g. treating hypoglycaemia) and Reflective (e.g. reviewing blood glucose data to identify patterns). Thirty-four barriers and five enablers were identified: 10 relating to Capability, 20 to Opportunity and nine to Motivation. CONCLUSIONS: Multiple behaviours within three self-management cycles are involved in sustained type 1 diabetes self-management. There are a wide range of barriers and enablers that should be addressed to support self-management behaviours and improve clinical outcomes. The present study provides an evidence base for refining and developing type 1 diabetes self-management programmes.

Preparing for animal health emergencies: considerations for economic evaluation.

Livestock production systems and the societies in which they are embedded face a set of risks presented by infectious diseases and natural and human-made disasters which compromise animal health. Within this set, threats are posed by natural, deliberate and accidental actions that can cause sudden changes in animal health status, requiring the allocation of additional resources to manage animal health. Determining the benefit of preparing for such emergencies is a challenge when the total set of risks includes the unknown. Any method for analysing the economic costs and benefits of animal health emergencies must not only accommodate this uncertainty, but make it a central feature of the analysis. Cost-benefit analysis is a key approach to economically evaluating animal health interventions. However, the value of this approach in dealing with uncertainty is often called into question. This paper makes the case that, by restricting the outcomes of an emergency event to specified states of nature, boundaries can be placed on the uncertainty space, allowing cost-benefit analysis to be performed. This method, which merges state-contingent analysis with cost-benefit analysis, is presented here. Further discussion on the economic characteristics of emergency events, and the nature of the threats posed to animal health systems, is also provided.

Les systèmes de production animale et les sociétés dans lesquelles ils s'inscrivent doivent faire face à une série de risques associés à des maladies infectieuses ou à des catastrophes d'origine naturelle ou anthropique, qui représentent une menace pour la santé animale. Parmi ces risques, certaines menaces résultant d'actions naturelles, délibérées ou accidentelles peuvent modifier de manière drastique la situation sanitaire des cheptels et imposer d'allouer des ressources supplémentaires à la gestion de la santé animale. Il est difficile de déterminer à l'avance les bénéfices apportés par la préparation aux urgences dès lors que la série complète des risques à envisager comporte des éléments inconnus. Les méthodes d'analyse des coûts et des bénéfices économiques appliquées aux urgences de santé animale doivent non seulement tenir compte de cette incertitude, mais la placer au cœur de l'analyse. L'analyse coûts-bénéfices est une méthode clé pour évaluer les interventions de santé animale dans une perspective économique. Néanmoins, la capacité de cette méthode à traiter l'incertitude est souvent mise en cause. Les auteurs soutiennent qu'en limitant l'analyse des répercussions d'une situation d'urgence à certains états spécifiques de la nature, il devient possible de poser des bornes à l'étendue de l'incertitude, ce qui permet de réaliser une analyse couts-bénéfices. Ils présentent cette méthode, qui consiste à combiner l'analyse des incertitudes dépendantes d'un état de choses donné (state-contingent analysis), avec une analyse coûts-bénéfices. Ils examinent ensuite les caractéristiques économiques des situations d'urgence ainsi que la nature des menaces que ces dernières font peser sur les systèmes de santé animale.

Los sistemas de producción pecuaria y las sociedades en las que están inscritos afrontan una serie de riesgos derivados de enfermedades infecciosas y de desastres de origen natural y humano que ponen en peligro la sanidad animal. Dentro de esta panoplia de riesgos están las amenazas derivadas de sucesos naturales o actos deliberados o accidentales que puedan inducir un cambio repentino de la situación zoosanitaria y exigir recursos adicionales para gestionarla. La determinación de los beneficios que pueda traer consigo la preparación para tales emergencias no es tarea fácil, cuando «lo desconocido¼ forma parte del conjunto de riesgos que se afrontan. Todo método encaminado a analizar los costos económicos y eventuales beneficios en el ámbito de las emergencias zoosanitarias debe no solo integrar esta incertidumbre, sino hacer de ella el elemento central del análisis. El análisis de la relación costo-beneficio es un procedimiento clave para evaluar económicamente las intervenciones de sanidad animal, aunque a menudo se cuestiona su utilidad o idoneidad para manejar la incertidumbre. Los autores postulan que, restringiendo los resultados de un suceso de emergencia a un conjunto especificado de estados de la naturaleza, es posible delimitar el espacio de incertidumbre y, con ello, efectuar un análisis de costos-beneficios. Los autores presentan este método, que consiste en combinar el análisis de las incertidumbres dependientes de un determinado estado de cosas (state-contingent analysis) y el análisis de la relación costo-beneficio. También se detienen a examinar las características económicas de los sucesos de emergencia y el tipo de amenazas que pesan sobre los sistemas de sanidad animal.

The gulf between emergency plans and the resources needed: a global review.

Preparedness for an animal emergency event reduces a country's economic and production losses and decreases animal disease threats to neighbouring countries. Investing in animal disease preparedness reduces economic expenditures during an emergency as well as in recovery. An essential component of animal disease preparedness is a national contingency plan that is fit for purpose. This useful document should be frequently updated and can be modified with new information from self-assessments and after-action reports, which should identify resource needs and improvements to be made. National contingency plans are recommended in global international guidance and by animal health and veterinary organisations. Despite this, some countries lack national contingency plans that are fit for purpose, or the resources to implement them. This review concentrates on trends in national contingency planning around the world. In 2018 and 2019, the authors surveyed existing global animal disease contingency plans. Of the 181 Members of the World Organisation for Animal Health (OIE), 163 were reported to have some form of national contingency plan. (Over the course of the review from 2018 to 2019, the 182nd Member joined the OIE. This review examines only the 181 that were Members when the survey began.) The authors review current global animal emergency preparedness and discuss the gaps that have been identified. They discuss global trends, examining developing concepts and novel approaches that may aid improvements in global national contingency planning and enhance the global capacity to prepare for animal disease where gaps exist.

La préparation aux urgences de santé animale atténue les pertes économiques et productives des pays affectés et réduit la menace de propagation de maladies aux pays voisins. Les investissements dédiés à la préparation aux maladies animales réduisent les dépenses économiques durant l'urgence ainsi que pendant la phase de redressement. L'une des composantes essentielles de la préparation aux situations d'urgence zoosanitaire est le plan national d'intervention, qui doit être adapté aux objectifs visés. Il convient de mettre à jour régulièrement ce document de programmation et de le modifier au vu des renseignements nouveaux émanant des autoévaluations ou des rapports postérieurs à l'adoption de mesures ­ lesquels doivent préciser les ressources requises et les améliorations à apporter. Les directives internationales et les organisations vétérinaires et de santé animale recommandent de se doter de plans nationaux d'intervention d'urgence. Pourtant, certains pays ne disposent ni de plans nationaux d'intervention adaptés aux objectifs visés, ni des ressources nécessaires à leur mise en œuvre. L'analyse présentée par les auteurs est axée sur les tendances observées dans le monde en matière de planification nationale des interventions d'urgence. En 2018 et 2019, les auteurs ont fait le point sur les plans d'urgence existants dans le domaine de la santé animale. Il ressort de leur enquête que 163 des 181 Membres de l'Organisation mondiale de la santé animale (OIE) disposaient d'un plan national d'urgence, sous une forme ou une autre. (Au cours de cette enquête conduite de 2018 à 2019, un 182e Membre a adhéré à l'OIE. L'analyse présentée par les auteurs ne concerne que les 181 pays ayant la qualité de Membre au début de l'enquête.) Les auteurs passent en revue le niveau actuel de préparation aux urgences zoosanitaires dans le monde et analysent les lacunes constatées. Ils évoquent les tendances mondiales et soulignent les concepts en cours d'élaboration ainsi que les approches novatrices susceptibles de contribuer à l'amélioration des plans nationaux d'intervention d'urgence à l'échelle mondiale et au renforcement des capacités de préparation aux maladies animales dans les pays où des lacunes existent encore.

La preparación para episodios de emergencia relacionados con los animales reduce las pérdidas económicas y de producción que sufre un país y rebaja el nivel de las amenazas zoosanitarias que pesan sobre los países vecinos. El hecho de invertir en la preparación para enfermedades animales reduce los gastos no solo cuando adviene la emergencia, sino también durante la fase de recuperación. Uno de los componentes básicos de este proceso de preparación es un plan nacional de emergencia que esté adaptado a su finalidad. Se trata de un documento muy útil, que conviene actualizar con frecuencia y puede ser enriquecido a medida que los procesos de autoevaluación y los informes retrospectivos (que ayudan a determinar los recursos necesarios y las mejoras requeridas) vayan deparando nueva información. Tanto las guías internacionales de ámbito mundial como las organizaciones de sanidad animal y veterinaria recomiendan disponer de un plan nacional de emergencia. Pese a ello, hay países que carecen de un plan de este tipo adaptado a sus fines o de los recursos necesarios para ponerlo en práctica. Los autores se centran aquí en las tendencias en todo el mundo de los procesos de elaboración de planes nacionales de emergencia. En 2018 y 2019 examinaron los planes para emergencias zoosanitarias existentes en el mundo y constataron que, de los 181 Países Miembros de la Organización Mundial de Sanidad Animal (OIE), 163 disponen de algún tipo de plan nacional de emergencia. (Entre 2018 y 2019, en el curso del estudio, un nuevo País Miembro, el 182º, se incorporó a la OIE, pero los resultados aquí descritos se refieren solo a los 181 que eran Miembros cuando empezó el estudio.) Los autores describen la situación mundial actual en cuanto a preparación para emergencias relacionadas con los animales y señalan las carencias detectadas. Después exponen las tendencias de ámbito mundial, examinando conceptos nacientes y planteamientos novedosos que pueden ayudar a mejorar la elaboración en el mundo de planes nacionales de emergencia y a reforzar la capacidad general de preparación para enfermedades animales allí donde existen deficiencias.

Habit-based workplace physical activity intervention: a pilot study.

BACKGROUND: Increasing workplace physical activity has important implications for workers' health and well-being. However, few interventions targeting physical activity in the workplace are grounded in behavioural theory. AIMS: The aim of this study was to develop and pilot a 6-week habit-based intervention designed to promote the development of workplace physical activity habits and increase average weekly step counts. Changes in the strength of workplace physical activity habit and weekly step counts were assessed at 1 and 6 weeks following the intervention. METHODS: The study was a prospective three-wave within-subjects single-arm intervention study that ran for 12 weeks (baseline, 7 weeks, 12 weeks). During the 6-week intervention, participants received information regarding 10 top tips (10TT) to increase and promote habit formation and wore a pedometer during work hours. Differences in workplace physical activity habit and weekly step counts were compared across baseline (T1), 1 (T2) and 6 weeks (T3) post-intervention using repeated measures analyses of variance. RESULTS: Data from 20 sedentary office workers at a large Australian University were included. The average strength of workplace physical activity habits significantly increased from baseline (M = 3.90) to 1 week post-intervention (M = 4.45), and these effects were maintained 6 weeks later (M = 4.72). No significant increase in step counts were observed across any of the time points (all P > 0.05). CONCLUSIONS: The results of this pilot study reveal that workplace physical activity habits can be strengthened via a habit-based intervention. Further research is needed to replicate these findings in larger cohorts of office workers.

Predicting fruit and vegetable consumption in long-haul heavy goods vehicle drivers: Application of a multi-theory, dual-phase model and the contribution of past behaviour.

Fruit and vegetable intake is insufficient in industrialized nations and long-haul heavy goods vehicle (HGV) drivers are considered a particularly at-risk group. The aim of the current study was to test the effectiveness of a multi-theory, dual-phase model to predict fruit and vegetable consumption in Australian long-haul HGV drivers. A secondary aim was to examine the effect of past fruit and vegetable consumption on model paths. A prospective design with two waves of data collection spaced one week apart was adopted. Long-haul HGV drivers (N = 212) completed an initial survey containing theory-based measures of motivation (autonomous motivation, intention), social cognition (attitudes, subjective norms, perceived behavioural control), and volition (action planning, coping planning) for fruit and vegetable consumption. One week later, participants (n = 84) completed a self-report measure of fruit and vegetable intake over the previous week. A structural equation model revealed that autonomous motivation predicted intentions, mediated through attitudes and perceived behavioural control. It further revealed that perceived behavioural control, action planning, and intentions predicted fruit and vegetable intake, whereby the intention-behaviour relationship was moderated by coping planning. Inclusion of past behaviour attenuated the effects of these variables. The model identified the relative contribution of motivation, social cognition, and volitional components in predicting fruit and vegetable intake of HGV drivers. Consistent with previous research, inclusion of past fruit and vegetable consumption led to an attenuation of model effects, particularly the intention-behaviour relationship. Further investigation is needed to determine which elements of past behaviour exert most influence on future action.

Interaction of preservation methods and radiation sterilization in human skin processing, with particular insight on the impact of the final water content and collagen disruption. Part I: process validation, water activity and collagen changes in tissues cryopreserved or processed using 50, 85 or 98% glycerol solutions.

Current regulatory requirements demand an in-depth understanding and validation of protocols used in tissue banking. The aim of this work was to characterize the quality of split thickness skin allografts cryopreserved or manufactured using highly concentrated solutions of glycerol (50, 85 or 98%), where tissue water activity (aw), histology and birefringence changes were chosen as parameters. Consistent aw outcomes validated the proposed processing protocols. While no significant changes in tissue quality were observed under bright-field microscopy or in collagen birefringence, in-process findings can be harnessed to fine-tune and optimize manufacturing outcomes in particular when further radiation sterilization is considered. Furthermore, exposing the tissues to 85% glycerol seems to derive the most efficient outcomes as far as aw and control of microbiological growth.

Hormone signaling and fatty liver in females: analysis of estrogen receptor α mutant mice.

BACKGROUND: Treatment with estrogen in early menopausal women protects against development of hepatic steatosis and nonalcoholic fatty liver disease but estrogen has undesirable side effects, which negate its beneficial effects in premenopausal and postmenopausal women. Targeted therapies require better understanding of the target sites and mechanisms by which estrogen signaling exerts its protective effects in women. Estrogen receptor α (ERα) is thought to be the primary mediator for estrogen signaling to protect against hepatic steatosis. ERα has several mechanisms for signal transduction: (1) inducing gene transcription by direct binding to specific DNA sequences, (2) inducing tethered transcription with other DNA-binding factors, and (3) stimulating nongenomic action through membrane-associated ERα. However, it is still unclear which mechanisms mediate ERα-dependent protection against hepatic steatosis. METHODS: To understand the mechanisms of estrogen signaling for protection against hepatic steatosis in females, we analyzed the global ERα knockout mouse (αERKO), ERα DNA-binding domain mutant mouse (KIKO) and liver-specific ERα knockout mouse (LERKO) fed high-fat diets (HFD). The KIKO mouse disrupts the direct DNA-binding transcription activity but retains tethered transcription regulation and nongenomic action. Hepatic steatosis was evaluated by scoring the macrovesicular and microvesicular steatosis as well as serum alanine aminotransferase (ALT) levels. We analyzed serum testosterone to assess its correlation with hepatic steatosis. RESULTS: Liver fat accumulation was far greater in HFD-fed αERKO and KIKO females than in HFD-fed wild-type (WT) controls. Conversely, HFD-fed LERKO females did not accumulate excess liver fat. HFD-fed αERKO and KIKO females showed higher microvesicular steatosis and ALT levels than WT controls that correlated with increased serum testosterone levels. CONCLUSIONS: ERα-mediated direct transcription in non-hepatic tissues is essential for estrogen-mediated protection against hepatic steatosis in HFD-fed females. The balance between non-hepatic estrogen signaling and hepatic or non-hepatic testosterone action may control hepatic steatosis.

Rinderpest eradication: challenges for remaining disease free and implications for future eradication efforts.

In 2011, the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) declared global freedom from rinderpest, formally announcing that rinderpest virus infections had been eliminated from susceptible livestock populations. At the same time, it was recognised that rinderpest virus, and material containing rinderpest virus, remained stored in an unspecified number of facilities across the world. Although natural infections had been eliminated, there remained a risk that rinderpest could reoccur if such infectious material accidentally leaked or was intentionally released from one of these facilities into a susceptible animal population. To minimise this risk, the OIE and FAO, with the support of international partners, set in place a framework to: reduce the quantity of remaining rinderpest-virus-containing material; ensure that such material was only stored in high-security facilities; regulate any handling or manipulation of the virus; maintain vigilance amongst livestock keepers and Veterinary Services in the post-eradication era; and develop contingency plans to deal with any suspected or actual reoccurrence of rinderpest disease. In 2016, five years after the declaration of global freedom from rinderpest, official reports to the OIE show that virus and virus-containing material remain stored in 21 countries worldwide in 22 separate facilities, of which only five have been inspected and approved for holding rinderpest virus or vaccine. There is still much work to be done to further reduce the risk of a reoccurrence.

En 2011, l'Organisation mondiale de la santé animale (OIE) et l'Organisation des Nations Unies pour l'alimentation et l'agriculture (FAO) ont annoncé officiellement l'élimination de l'infection due au virus de la peste bovine dans les populations d'animaux d'élevage sensibles, déclarant ainsi la planète indemne de cette maladie. Parallèlement, les deux organisations faisaient état de l'existence d'un nombre indéterminé d'établissements dans le monde détenant des stocks du virus bovipestique ainsi que des produits contenant ce virus. Malgré l'élimination de l'infection chez ses hôtes naturels, un risque de réapparition de la peste bovine subsiste en cas de fuite accidentelle ou d'émission délibérée de ces produits infectieux dans les populations animales sensibles à partir de l'un de ces établissements. Afin de minimiser ce risque, l'OIE et la FAO soutenus par leurs partenaires internationaux ont mis en place un cadre visant plusieurs objectifs : réduire les quantités restantes de produits contenant le virus de la peste bovine dans le monde ; veiller à ce que ces produits ne soient stockés que dans des établissements de haute sécurité ; réglementer les conditions de détention et de manipulation du virus ; poursuivre la surveillance exercée par les éleveurs et les Services vétérinaires au cours de la phase post-éradication ; concevoir des plans d'urgence visant à faire face à toute réapparition suspectée ou confirmée de la peste bovine. En 2016, soit cinq ans après la déclaration de l'éradication mondiale de la peste bovine, il ressort des rapports officiels adressés à l'OIE que 21 pays détiennent encore des stocks du virus de la peste bovine ou des produits contenant ce virus, répartis en 22 établissements distincts dont seulement cinq ont fait l'objet d'une inspection et ont été dûment habilités à détenir des stocks de virus de la peste bovine ou de vaccins contre cette maladie. Il reste donc encore beaucoup à faire pour continuer à réduire le risque de réapparition de la peste bovine.

En 2011, la Organización Mundial de Sanidad Animal (OIE) y la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO) anunciaron oficialmente que las infecciones causadas por el virus de la peste bovina habían sido eliminadas de las poblaciones sensibles de ganado, declarando así que el mundo quedaba libre de la enfermedad. Al mismo tiempo, significaron que un número no especificado de instalaciones dispersas por el mundo albergaban muestras del virus y otros productos que lo contenían. Aunque las infecciones naturales habían quedado eliminadas, subsistía el riesgo de reaparición de la peste bovina si en una de esas instalaciones se producía una fuga accidental o una liberación intencionada de material infeccioso y este entraba en contacto con una población animal sensible. Para reducir al mínimo tal riesgo, la OIE y la FAO, con apoyo de colaboradores internacionales, definieron un dispositivo encaminado a: reducir el volumen de material restante con contenido viral de la peste bovina; garantizar que ese material fuera conservado únicamente en instalaciones de alta seguridad; reglamentar toda manipulación del virus; mantener la vigilancia entre cuidadores de ganado y Servicios Veterinarios en el periodo posterior a la erradicación; y elaborar planes de emergencia para responder a toda reaparición, presunta o confirmada, de la peste bovina. En 2016, cinco años después de la declaración de ausencia mundial de peste bovina, los informes oficiales remitidos a la OIE daban fe de que había virus y productos que lo contenían en 22 instalaciones situadas en 21 países del mundo, de las que solo cinco habían sido inspeccionadas y homologadas para albergar virus de la peste bovina o vacunas contra la enfermedad. Queda pues mucho trabajo por delante para reducir en mayor medida el riesgo de reaparición.

Evidence of Avian and Possum Fecal Contamination in Rainwater Tanks as Determined by Microbial Source Tracking Approaches.

UNLABELLED: Avian and possum fecal droppings may negatively impact roof-harvested rainwater (RHRW) water quality due to the presence of zoonotic pathogens. This study was aimed at evaluating the performance characteristics of a possum feces-associated (PSM) marker by screening 210 fecal and wastewater samples from possums (n = 20) and a range of nonpossum hosts (n = 190) in Southeast Queensland, Australia. The host sensitivity and specificity of the PSM marker were 0.90 and 0.95 (maximum value, 1.00), respectively. The mean concentrations of the GFD marker in possum fecal DNA samples (8.8 × 10(7) gene copies per g of feces) were two orders of magnitude higher than those in the nonpossum fecal DNA samples (5.0 × 10(5) gene copies per g of feces). The host sensitivity, specificity, and concentrations of the avian feces-associated GFD marker were reported in our recent study (W. Ahmed, V. J. Harwood, K. Nguyen, S. Young, K. Hamilton, and S. Toze, Water Res 88:613-622, 2016, http://dx.doi.org/10.1016/j.watres.2015.10.050). The utility of the GFD and PSM markers was evaluated by testing a large number of tank water samples (n = 134) from the Brisbane and Currumbin areas. GFD and PSM markers were detected in 39 of 134 (29%) and 11 of 134 (8%) tank water samples, respectively. The GFD marker concentrations in PCR-positive samples ranged from 3.7 × 10(2) to 8.5 × 10(5) gene copies per liter, whereas the concentrations of the PSM marker ranged from 2.0 × 10(3) to 6.8 × 10(3) gene copies per liter of water. The results of this study suggest the presence of fecal contamination in tank water samples from avian and possum hosts. This study has established an association between the degradation of microbial tank water quality and avian and possum feces. Based on the results, we recommend disinfection of tank water, especially for tanks designated for potable use. IMPORTANCE: The use of roof-harvested rainwater (RHRW) for domestic purposes is a globally accepted practice. The presence of pathogens in rainwater tanks has been reported by several studies, supporting the necessity for the management of potential health risks. The sources of fecal pollution in rainwater tanks are unknown. However, the application of microbial source tracking (MST) markers has the potential to identify the sources of fecal contamination in a rainwater tank. In this study, we provide evidence of avian and possum fecal contamination in tank water samples using molecular markers. This study established a potential link between the degradation of the microbial quality of tank water and avian and possum feces.

Public health implications of Acanthamoeba and multiple potential opportunistic pathogens in roof-harvested rainwater tanks.

A study of six potential opportunistic pathogens (Acanthamoeba spp., Legionella spp., Legionella longbeachae, Pseudomonas aeruginosa, Mycobacterium avium and Mycobacterium intracellulare) and an accidental human pathogen (Legionella pneumophila) in 134 roof-harvested rainwater (RHRW) tank samples was conducted using quantitative PCR (qPCR). All five opportunistic pathogens and accidental pathogen L. pneumophila were detected in rainwater tanks except Legionella longbeachae. Concentrations ranged up to 3.1×10(6) gene copies per L rainwater for Legionella spp., 9.6×10(5) gene copies per L for P. aeruginosa, 6.8×10(5) gene copies per L for M. intracellulare, 6.6×10(5) gene copies per L for Acanthamoeba spp., 1.1×10(5) gene copies per L for M. avium, and 9.8×10(3) gene copies per L for L. pneumophila. Among the organisms tested, Legionella spp. (99% tanks) were the most prevalent followed by M. intracellulare (78%). A survey of tank-owners provided data on rainwater end-uses. Fecal indicator bacteria (FIB) Escherichia coli and Enterococcus spp. were enumerated using culture-based methods, and assessed for correlations with opportunistic pathogens and L. pneumophila tested in this study. Opportunistic pathogens did not correlate well with FIB except E. coli vs. Legionella spp. (tau=0.151, P=0.009) and E. coli vs. M. intracellulare (tau=0.14, P=0.015). However, M. avium weakly correlated with both L. pneumophila (Kendall's tau=0.017, P=0.006) and M. intracellulare (tau=0.088, P=0.027), and Legionella spp. also weakly correlated with M. intracellulare (tau=0.128, P=0.028). The presence of these potential opportunistic pathogens in tank water may present health risks from both the potable and non-potable uses documented from the current survey data.

Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer.

OBJECTIVE: Androgen deprivation therapy (ADT) for the management of prostate cancer results in a range of side effects including sexual dysfunction. Exercise is proposed as a potentially effective therapy to counteract changes in sexual function. The current study explored the impact of ADT on men's sexuality and the effect of exercise on this experience. METHODS: Semi-structured, in-depth interviews were conducted with 18 men (age = 63.1 ± 3.8) who were on ADT for prostate cancer for ≤12 months and who were part of a pre-existing exercise intervention trial. RESULTS: Sexual concerns for men included changes in body image, partner relationships, sex drive, sexual performance and masculinity. In coping with these concerns, men described a sense of personal acceptance of sexual changes through a shift in priorities and values away from penetrative sexual intercourse, knowledge and understanding about ADT, and partner support. Exercise in a group-based setting contributed to the acceptance of sexual changes through affirming strength-based aspects of masculinity and peer support. CONCLUSION: Exercise appears to have utility as a strategy to assist men to manage the negative impact of ADT on sexuality and masculinity more broadly.

Pedestrian deaths in children--potential for prevention.

The National Paediatric Mortality Database was reviewed for the six year period 1st January 2006 to 31st December 2011 and all pedestrian deaths extracted, after review of available data the deaths were categorized as either traffic or non-traffic related. There were 45 child pedestrian fatalities in the period examined. Traffic related deaths accounted for 26 (58%) vs. 19 (42%) non-traffic related. Analysis of the deaths showed there was a male preponderance 28 (62%), weekend trend 22 (49%) with an evening 16 (35%) and summer peak 20 (44%). The highest proportion of deaths occurred in the 1-4 year age group 24 (53%), with 13 (28%) due to low speed vehicle rollovers, mainly occurring in residential driveways 8 (61%). Child pedestrian fatalities are highly preventable through the modification of risk factors including behavioural, social and environmental. Preventative action needs to be addressed, particularly in relation to non-traffic related deaths i.e, low speed vehicle rollovers.

The old-world Zygonini tr. nov. (Hemiptera, Cercopoidea, Clastopteridae), with new taxa from the related Machaerotinae.

Three new species of old-world Clastopteridae belonging to Machaerotinae are described, two in new monobasic genera: Allox transfigurata (Hindolini) from Borneo and Irridiculum deformatum (Machaerotini) from Sulawesi. One new species Machaeropsis dramatica (Hindolini) is described from Borneo. It is the first male known from the genus and shows that Machaeropsis Melichar is not synonymous with Metaenderleinia Lallemand. Five other new species are described, belonging to a new, related tribe Zygonini. Two of these new species (Ambonga lanceolata and Pseudomachaerota cucullata) belong to formerly monobasic genera from Madagascar incorrectly assigned to Cercopidae and Aphrophoridae respectively. These are related to 3 new genera: (1) from Madagascar, Pseudoclastoptera with new species P. irrubesco and P. invidia; from sub-Saharan Africa, (2) Zygon with 1 new species Z. desegregatum, and (3) Hemizygon, the latter with 2 new combinations from Pseudomachaerota: H. grande (Maa) and H. saturnus (Linnavuori). Zygon is possibly the most basal genus in Clastopteridae, according to its remarkable antennal characters with 5 different types of sensilla that show how basiconic and coeloconic sensilla are homodynamous. Genera related to Zygon are widely divergent from other spittlebugs as measured by mDNA "barcode" data from the COI gene.

Wastewater-based epidemiology as a public health resource in low- and middle-income settings.

In the face of emerging and re-emerging diseases, novel and innovative approaches to population scale surveillance are necessary for the early detection and quantification of pathogens. The last decade has seen the rapid development of wastewater and environmental surveillance (WES) to address public health challenges, which has led to establishment of wastewater-based epidemiology (WBE) approaches being deployed to monitor a range of health hazards. WBE exploits the fact that excretions and secretions from urine, and from the gut are discharged in wastewater, particularly sewage, such that sampling sewage systems provides an early warning system for disease outbreaks by providing an early indication of pathogen circulation. While WBE has been mainly used in locations with networked wastewater systems, here we consider its value for less connected populations typical of lower-income settings, and in assess the opportunity afforded by pit latrines to sample communities and localities. We propose that where populations struggle to access health and diagnostic facilities, and despite several additional challenges, sampling unconnected wastewater systems remains an important means to monitor the health of large populations in a relatively cost-effective manner.

Revision of Neotropical aphrophorine spittlebugs, part 2: tribe Orthoraphini (Hemiptera, Cercopoidea).

The tribe Orthoraphini is validated by diagnosis to include the new-world fauna of Orthorapha Westwood with 21 species from Brazil and 2 newly recorded from Bolivia, including 9 new species: boliviana from an unknown locality in Bolivia and decorata, inscripta, inflata, invidia, irregularis, oculata, sagittata and sphaerata from Brazil. There are also 10 new combinations from Lepyronia Amyot & Serville: bufo Walker; concinna Stål, frontalis Stål, fusconotata Stål, geminata Jacobi, obscurata Amyot & Serville, obliqua Jacobi, quadrimaculata Lallemand, rana Walker and subfasciata Amyot & Serville. Keys are presented to the new-world species and 3 subgenera, including Lepyronoxia Melichar, stat.nov. (= Balsana Metcalf, syn.nov.) and Balsania subg.nov. In addition, the tribe contains 15 genera of old-world Aphrophorinae with an estimated 290 species from Pacific islands; of these, the previously undescribed male genitalia from 25 species in 8 genera are illustrated and antennal characters for Orthorapha and 14 Pacific island genera of Orthoraphini are compared to those of Cloviini, Philaenini and Aphrophorini. This is the first tribe of Cercopoidea to be described as limited to the Southern Hemisphere.

First test of the theory of reasoned goal pursuit: predicting physical activity.

OBJECTIVE: This study applied the theory of reasoned goal pursuit (TRGP) in predicting physical activity among Australian undergraduate students, providing the first empirical test of the model.Methods: The research comprised an elicitation study (N = 25; MAge= 25.76, SDAge= 11.33, 20 female, 5 male) to identify readily accessible procurement and approval goal beliefs and behavioural, normative, and control beliefs; and, a two-wave prospective online survey study (N = 109; MAge = 21.88, SDAge = 7.04, 63 female, 46 male) to test the tenets of the TRGP in relation to meeting World Health Organization physical activity guidelines during the COVID-19 pandemic among first year university students.Results: A linear PLS-SEM model displayed good fit-to-data, predicting 38%, 74%, and 48% of the variance in motivation, intention, and physical activity, respectively. The model supported the majority of hypothesised pattern of effects among theory constructs; in particular, the proposition that beliefs corresponding to procurement and approval goals would be more consequential to people's motivation and, thus, their intentions and behaviour, than other behavioural and normative beliefs, respectively.Conclusions: Results lend support for the TRGP and sets the agenda for future research to systematically test the proposed direct, indirect, and moderation effects for different health behaviours, populations, and contexts.Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2026946 .

Inhibition of farnesyltransferase induces regression of mammary and salivary carcinomas in ras transgenic mice.

For Ras oncoproteins to transform mammalian cells, they must be post-translationally modified with a farnesyl group in a reaction catalysed by the enzyme farnesyl-protein transferase (FPTase). Inhibitors of FPTase have therefore been proposed as anti-cancer agents. We show that L-744,832, which mimics the CaaX motif to which the farnesyl group is added, is a potent and selective inhibitor of FPTase. In MMTV-v-Ha-ras mice bearing palpable tumours, daily administration of L-744,832 caused tumour regression. Following cessation of treatment, tumours reappeared, the majority of which regressed upon retreatment. No systemic toxicity was found upon necropsy of L-744,832-treated mice. This first demonstration of anti-FPTase-mediated tumour regression suggests that FPTase inhibitors may be safe and effective anti-tumour agents in some cancers.

Group cognitive-behavioral therapy for patients with epilepsy and comorbid depression and anxiety.

Clinical Practice Guidelines for depression and anxiety recommend cognitive-behavioral therapy (CBT) as an equivalent and sometimes more effective treatment than medication. The limited research investigating CBT for anxiety and depression in epilepsy demonstrates mixed results. Described here is a pilot project using an existing group CBT intervention for symptoms of depression and/or anxiety, CBT Basics II, in patients with epilepsy. Eighteen patients with epilepsy, referred by neurologists to address depression and/or anxiety symptoms, completed the 10-week group. Results demonstrated improvements in depression, anxiety, negative automatic thoughts, and cognitive therapy knowledge and skills. The group was generally acceptable to patients as indicated by good attendance rates and only one dropout. This pilot project demonstrates that group CBT is a feasible, acceptable, and promising intervention for patients with epilepsy and comorbid depression and anxiety symptoms.

A preliminary examination of the effects of genetic variants of redox enzymes on susceptibility to oedematous malnutrition and on percentage cytotoxicity in response to oxidative stress in vitro.

BACKGROUND: The causes of oedematous vs non-oedematous childhood malnutrition (OM vs NOM) remain elusive. It is possible that inherited differences in handling oxidant stressors are a contributing factor. AIMS: To test for associations between polymorphisms in five genes and (i) risk of OM, a case-control study, and (ii) percentage cytotoxicity in peripheral blood mononuclear cells (PBMCs) exposed to hydrogen peroxide (H(2)O(2)), an in vitro cell challenge study. METHODS: Participants had been admitted previously for treatment of OM (cases, n = 74) or NOM (controls, n = 50), or were an independent set of healthy pregnant women (n = 47) who donated peripheral blood mononuclear cells. We tested for associations between genetic variation and outcome using single markers or a bivariate score constructed by counting numbers of deleterious alleles for each of 15 possible pairs of markers. RESULTS: In the case-control study there were no significant single-marker associations with OM. We did find that higher bivariate scores were associated with OM for the pair of NAD(P)H:quinone oxidoreductase 1 and catalase (odds ratio 2·00, 95% CI 1·05-3·82). In the cell challenge experiments, there were no significant associations with percentage cytotoxicity. CONCLUSIONS: Variation in this small set of genes seems unlikely to have a large impact on either risk of OM or cytotoxicity after H(2)O(2) exposure. The use of larger sample sizes to test the effects of a much larger set of genetic variants will be required in order to determine whether genetic variation contributes to the risk of OM. Such studies have potential for improving our understanding of causal pathways in OM.

The influence of economic indicators, poultry density and the performance of veterinary services on the control of high-pathogenicity avian influenza in poultry.

High-pathogenicity avian influenza (HPAI) and low-pathogenicity notifiable avian influenza (LPNAI) in poultry are notifiable diseases that must be reported to the World Organisation for Animal Health (OIE). There are variations between countries' responses to avian influenza (AI) outbreak situations based on their economic status, diagnostic capacity and other factors. The objective of this study was to ascertain the significant association between HPAI control data and a country's poultry density, the performance of its Veterinary Services, and its economic indicators (gross domestic product, agricultural gross domestic product, gross national income, human development index and Organisation for Economic Co-operation and Development [OECD] status). Results indicate that as poultry density increases for least developed countries there is an increase in the number and duration of HPAI outbreaks and in the time it takes to eradicate the disease. There was no significant correlation between HPAI control and any of the economic indicators except membership of the OECD. Member Countries, i.e. those with high-income economies, transparency and good governance, had shorter and significantly fewer HPAI outbreaks, quicker eradication times, lower mortality rates and higher culling rates than non-OECD countries. Furthermore, countries that had effective and efficient Veterinary Services (as measured by the ratings they achieved when they were assessed using the OIE Tool for the Evaluation of Performance of Veterinary Services) had better HPAI control measures.