Health and security risks of humanitarian aid workers during field missions: Experience of the International Red Cross.

BACKGROUND: Humanitarian disaster environments put relief workers at risk, both physically and mentally. Research looking at the growing humanitarian workforce's health and working conditions is lacking. METHODS: A questionnaire was presented to ICRC (International Committee of the Red Cross) workers during debriefing between 2016 and 2018. Participants were queried about their experience abroad including security incidents (the primary objective), health, and malaria prevention. Descriptive statistics and multivariate logistic regressions were used for data analysis. RESULTS: Security incidents were reported by 12% (95/796) of expatriates, mainly armed threats and attacks (83%, 79/95). Accidents or injuries occurred for 7.5% (60/796), of which 42% (25/60) were due to sporting activities and 22% (13/60) to road accidents. Many engaged in risky behaviours (15%, 119/795), such as driving too fast or inebriated (37%, 44/119) and/or engaging in unsafe sex, (unfamiliar partner, no condom) (71%; 84/119). Compliance to malaria prophylaxis was low 43% (113/263). Over 40% (324/795) found the mission more stressful than expected. Almost a third (28%, 219/796) reported worsened health on their return. CONCLUSIONS: Humanitarian aid workers display a worsening of their health when on mission due to violence, accidents and risky behaviours. To preserve their staff's wellbeing, humanitarian organizations should pay attention to medical history, pre-travel training specific to assignment, and continuous medical and psychological support.

Diagnostic approach to encephalitis and meningoencephalitis in adult returning travellers.

BACKGROUND: Encephalitis and meningoencephalitis are severe, sometime life-threatening infections of the central nervous system. Travellers may be exposed to a variety of neurotropic pathogens. AIMS: We propose to review known infectious causes of encephalitis in adults acquired outside Europe, and how to identify them. SOURCES: We used Pubmed and Embase, to search the most relevant publications over the last years. CONTENT: Microbiologic tests and radiological tools to best identify the causative pathogen in travellers presenting with encephalitis and ME are presented in this narrative review, as well as a diagnostic approach tailored to the visited area and types of exposures. IMPLICATIONS: This review highlights the diagnostic difficulties inherent to exotic causes of central nervous system infections, and attempts to guide clinicians with respect to which microbiological tests to consider, in addition to brain MRI, when approaching a returning traveller presenting with encephalitis.

Diagnostic tools to tackle infectious causes of encephalitis and meningoencephalitis in immunocompetent adults in Europe.

BACKGROUND: Encephalitis and meningoencephalitis imply inflammation of the brain parenchyma, and comprise many diagnostic entities, such as various infections and causes of dysimmunity. The cause remains unknown in around 50% of cases. OBJECTIVES: To summarize the main infectious causes of encephalitis and meningoencephalitis acquired in Europe, and the diagnostic means to identify them. SOURCES: PubMed, ECDC and WHO websites, personal experience. CONTENT: The principal infectious causes of encephalitis and meningoencephalitis acquired in Europe in adults are discussed in this review, with special emphasis on the microbiological and imaging diagnostic approaches. The role of electroencephalography in diagnosing encephalitis is also mentioned. Among infections, viruses are more frequent than other pathogen types, and their epidemiology varies according to geographic area. A few bacteria, such as Listeria monocytogenes and Mycobacterium tuberculosis, are also to be considered. In contrast, parasites and fungi are rare encephalitis causes in Europe. IMPLICATIONS: Identifying the causative pathogen of infectious encephalitis and meningoencephalitis is complex because of the variety of pathogens, the epidemiology of which is determined by geography and environmental factors. Furthermore, despite extensive microbiological testing, many cases of encephalitis remain of unknown origin. Brain magnetic resonance imaging and electroencephalography are useful complementary diagnostic tools, and newer unbiased sequencing technologies might help to fill in the diagnostic gap.

Spatially resolved studies of the phases and morphology of methylammonium and formamidinium lead tri-halide perovskites.

The family of organic-inorganic tri-halide perovskites including MA (MethylAmmonium)PbI3, MAPbI3-xClx, FA (FormAmidinium)PbI3 and FAPbBr3 are having a tremendous impact on the field of photovoltaic cells due to the combination of their ease of deposition and high energy conversion efficiencies. Device performance, however, is known to be still significantly affected by the presence of inhomogeneities. Here we report on a study of temperature dependent micro-photoluminescence which shows a strong spatial inhomogeneity related to the presence of microcrystalline grains, which can be both bright and dark. In all of the tri-iodide based materials there is evidence that the tetragonal to orthorhombic phase transition observed around 160 K does not occur uniformly across the sample with domain formation related to the underlying microcrystallite grains, some of which remain in the high temperature, tetragonal, phase even at very low temperatures. At low temperature the tetragonal domains can be significantly influenced by local defects in the layers or the introduction of residual levels of chlorine in mixed halide layers or dopant atoms such as aluminium. We see that improvements in room temperature energy conversion efficiency appear to be directly related to reductions in the proportions of the layer which remain in the tetragonal phase at low temperature. In FAPbBr3 a more macroscopic domain structure is observed with large numbers of grains forming phase correlated regions.

[Elderly travellers: review and advices]. / Le senior en voyage: revue et conseils.

Thanks to improved health and transport means, an increasing number of elderly people travel. This population shows characteristics that necessitate adaptations of the pre-travel consultation. Travel-associated diseases are related to the presence of pre-existing underlying conditions. Indeed, a healthy elderly traveller does not have more risk to get sick during travel than a younger traveller. However, the frequency and severity of complications of some travel-related diseases are increased. The aim of the pre-travel consultation in elderly will not be restrained to the usual prevention advices and immunization, but will also evaluate the risks of decompensation of pre-existing comorbidities, adapt if necessary ongoing medications to the conditions of travel, and plan access to care in case of acute decompensation.

[Rickettsial diseases in Switzerland, update for the general practitioner]. / Rickettsioses d'importation.

Rickettsial diseases are arthropod-borne zoonosis. They are still misdiagnosed in Switzerland. Since development in molecular genetics, number of pathogenic species increased dramatically. In recent years, the incidence rise worldwide. Climatic conditions and development of tropical travels could explain it. In a near future, the Swiss general practitioner may face an increase of cases. Clinical presentation is unspecified. The eschar is the key diagnostic element but can be easily overlooked. Serology, the indirect immunofluorescence assay is the reference method. PCR can give the diagnosis in acute phase. However empirical treatment should be prescribed as soon as diagnosis is suspected. No vaccine is currently available and use of repellent is still the best way of prevention.

The effect of arterial PO2 on relative retinal blood flow in monkeys.

The relationship of blood oxygenation to retinal blood flow has been studies in rhesus monkeys. Constriction of major retinal arteries and veins during hyperoxia and dilation during hypoxia are demonstrated. Together with mean circulation times based on the technique of fluorescein densitometry curves, these data allow an estimation of retinal blood flow, which increases considerably in hypoxia and shows a moderate decrease in hyperoxia. These findings indicate that the retinal circulation parallels that of the brain in adjusting to changes in arterial PO2 with compensatory changes in blood flow.