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1.
BJPsych Bull ; : 1-7, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32090727

RESUMO

AIMS AND METHOD: To characterise police involvement with those detained under place of safety legislation and determine factors associated with admission to hospital. Place of safety referrals over a 1-year period were identified retrospectively and evaluated. RESULTS: Place of safety legislation is generally used with regard to concerns about suicide. Individuals are often removed from high-risk areas and referrals to police are frequently initiated by individuals themselves. A diagnosis of mental illness or personality disorder predicted hospital admission. Presence of senior nursing staff at assessment, but not the seniority of the doctor, was associated with discharge. CLINICAL IMPLICATIONS: Closer multiagency working is required as police are currently being recruited to fill a void between mental health services and the population they serve. Junior doctors require more senior support in making complex, and often risky, emergency management decisions with this population.

2.
Parasit Vectors ; 12(1): 536, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727162

RESUMO

BACKGROUND: Knowledge of Ixodes ricinus tick distribution is critical for surveillance and risk management of transmissible tick-borne diseases such as Lyme borreliosis. However, as the ecology of I. ricinus is complex, and robust long-term geographically extensive distribution tick data are limited, mapping often relies on datasets collected for other purposes. We compared the modelled distributions derived from three datasets with information on I. ricinus distribution (quantitative I. ricinus count data from scientific surveys; I. ricinus presence-only data from public submissions; and a combined I. ricinus dataset from multiple sources) to assess which could be reliably used to inform Public Health strategy. The outputs also illustrate the strengths and limitations of these three types of data, which are commonly used in mapping tick distributions. METHODS: Using the Integrated Nested Laplace algorithm we predicted I. ricinus abundance and presence-absence in Scotland and tested the robustness of the predictions, accounting for errors and uncertainty. RESULTS: All models fitted the data well and the covariate predictors for I. ricinus distribution, i.e. deer presence, temperature, habitat, index of vegetation, were as expected. Differences in the spatial trend of I. ricinus distribution were evident between the three predictive maps. Uncertainties in the spatial models resulted from inherent characteristics of the datasets, particularly the number of data points, and coverage over the covariate range used in making the predictions. CONCLUSIONS: Quantitative I. ricinus data from scientific surveys are usually considered to be gold standard data and we recommend their use where high data coverage can be achieved. However in this study their value was limited by poor data coverage. Combined datasets with I. ricinus distribution data from multiple sources are valuable in addressing issues of low coverage and this dataset produced the most appropriate map for national scale decision-making in Scotland. When mapping vector distributions for public-health decision making, model uncertainties and limitations of extrapolation need to be considered; these are often not included in published vector distribution maps. Further development of tools to better assess uncertainties in the models and predictions are necessary to allow more informed interpretation of distribution maps.


Assuntos
Distribuição Animal , Vetores Artrópodes , Confiabilidade dos Dados , Ixodes , Animais , Análise de Dados , Cervos , Ecossistema , Modelos Estatísticos , Saúde Pública , Escócia , Doenças Transmitidas por Carrapatos/prevenção & controle , Doenças Transmitidas por Carrapatos/transmissão
3.
Front Vet Sci ; 6: 190, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31275949

RESUMO

Traditionally, cost-benefit analyses (CBAs) focus on the direct costs of animal disease, including animal mortality, morbidity, and associated response costs. However, such approaches often fail to capture the wider, dynamic market impacts that could arise. The duration of these market dislocations could last well after an initial disease outbreak. More generally, current approaches also muddle definitions of indirect costs, confusing debate on the scope of the totalities of disease-induced economic impacts. The aim of this work was to clarify definitions of indirect costs in the context of animal diseases and to apply this definition to a time series methodological framework to estimate the indirect costs of animal disease control strategies, using a foot and mouth disease (FMD) outbreak in Scotland as a case study. Time series analysis is an econometric method for analyzing statistical relationships between data series over time, thus allowing insights into how market dynamics may change following a disease outbreak. First an epidemiological model simulated FMD disease dynamics based on alternative control strategies. Output from the epidemiological model was used to quantify direct costs and applied in a multivariate vector error correction model to quantify the indirect costs of alternative vaccine stock strategies as a result of FMD. Indirect costs were defined as the economic losses incurred in markets after disease freedom is declared. As such, our definition of indirect costs captures the knock-on price and quantity effects in six agricultural markets after a disease outbreak. Our results suggest that controlling a FMD epidemic with vaccination is less costly in direct and indirect costs relative to a no vaccination (i.e., "cull only") strategy, when considering large FMD outbreaks in Scotland. Our research clarifies and provides a framework for estimating indirect costs, which is applicable to both exotic and endemic diseases. Standard accounting CBAs only capture activities in isolation, ignore linkages across sectors, and do not consider price effects. However, our framework not only delineates when indirect costs start, but also captures the wider knock-on price effects between sectors, which are often omitted from CBAs but are necessary to support decision-making in animal disease prevention and control strategies.

4.
PLoS One ; 11(8): e0161990, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27564417

RESUMO

Statutory recording of carcass lesions at the abattoir may have significant potential as a resource for surveillance of livestock populations. Food Standards Agency (FSA) data in Great Britain are not currently used for surveillance purposes. There are concerns that the sensitivity of detection, combined with other issues, may make the outputs unreliable. In this study we postulate that FSA data could be used for surveillance purposes. To test this we compared FSA data with BPHS (a targeted surveillance system of slaughtered pigs) and laboratory diagnostic scanning surveillance (FarmFile) data, from mid-2008 to mid-2012, for respiratory conditions and tail bite lesions in pigs at population level. We also evaluated the agreement/correlation at batch level between FSA and BPHS inspections in four field trials during 2013. Temporal trends and regional differences at population level were described and compared using logistic regression models. Population temporal analysis showed an increase in respiratory disease in all datasets but with regional differences. For tail bite, the temporal trend and monthly patterns were completely different between the datasets. The field trials were run in three abattoirs and included 322 batches. Pearson's correlation and Cohen's kappa tests were used to assess correlation/agreement between inspections systems. It was moderate to strong for high prevalence conditions but slight for low prevalence conditions. We conclude that there is potential to use FSA data as a component of a surveillance system to monitor temporal trends and regional differences of chosen indicators at population level. At producer level and for low prevalence conditions it needs further improvement. Overall a number of issues still need to be addressed in order to provide the pig industry with the confidence to base their decisions on these FSA inspection data. Similar conclusions, at national level, may apply to other livestock sectors but require further evaluation of the inspection and data collection processes.


Assuntos
Matadouros , Vigilância da População/métodos , Bem-Estar do Animal , Animais , Inspeção de Alimentos/métodos , Gado , Sus scrofa , Suínos , Doenças dos Suínos , Reino Unido
5.
Afr J Infect Dis ; 10(2): 61-68, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28331915

RESUMO

BACKGROUND: Hepatitis B Virus (HBV) co-infection is prevalent among HIV infected individuals because of shared routes and mechanisms of transmission. The multidimensional immunosuppression from HIV infection causes impaired spontaneous recovery from an acute HBV infection, predisposing to chronic infection which is worsened by younger age at infection. Co-infection increases the risk of HBV replication, hepatotoxicity and liver related deaths from Highly Active Antiretroviral Therapy (HAART). The study was undertaken to highlight the burden of co-infection among HIV positive children in Enugu, determine the associated risk factors and compare the effect of co-infection between co-infected and non-co-infected children using liver enzyme and CD4 counts. MATERIALS AND METHODS: A cross sectional study was carried out among HIV positive children attending the Paediatric ARV clinic of the University of Nigeria Teaching Hospital, Ituku-Ozalla. A total of 140 HIV infected children aged 18 months to 15 years were recruited. An interviewer questionnaire was administered. Hepatitis B surface antigen (HBsAg) was determined using Determine test Kit. Baseline and recent CD4 counts/CD4% were retrieved from the patients' folders. RESULTS: Fourteen (10%) were positive for HBsAg. The highest prevalence of HBsAg was observed among children aged 11- 15 years. The higher the socioeconomic class the less likely the HBsAg positivity. Seven (50%) of the co-infected children had elevated baseline ALT compared with 57 (45.2%) of non-co-infected children though the difference was not statistically significant (t = 0.6, P = 0.56). After the initiation of HAART, 10 (76.9%) of the co-infected and 18 (15.1%) of the non-co-infected children had elevated ALT. The baseline median CD4 count among children ≥ 6 years was 230 cells/mm3 and 360 cells/mm3 respectively among the co-infected and non- co-infected, (P = 0.67). However, in children ≤ 5 years, it was 25% and 15 % respectively (P = 0.06). CONCLUSION: HBV co-infection among HIV infected children is common in our environment, and co-infection is associated with impaired immunity and probably liver enzyme derangement.

6.
Afr J Infect Dis ; 8(1): 5-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24653810

RESUMO

BACKGROUND: Hepatitis C virus (HCV) and Human Immunodeficiency virus (HIV), are major public health challenges in the developing world especially sub-Saharan Africa. The aim of this study was to determine the prevalence and risk factors of Hepatitis C virus infection among children infected with HIV. METHODS: This was a cross-sectional study conducted at the Paediatric HIV Clinic, UNTH, Enugu between July and December 2009. Antibodies to HCV were analyzed by newer generation rapid chromatographic immunoassay method using the Chromatest one step HCV test kit. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 15 statistical software. The chi squared test was used to test for significant association of categorical variables. A p-value of <0.05 was accepted as significant. RESULTS: One hundred and eighteen children HIV-infected children, aged between eighteen months to fifteen years were included in the data analysis. Eight of the HIV infected subjects were positive for HCV, giving an HIV-HCV co-infection prevalence of 6.8%. Co-infection was more prevalent among males and in those in age group 11-15 years. Blood transfusion, irrespective of frequency (p<0.015), and injections for immunization (p<0.049) were the significant risk factors noted. CONCLUSION: There is need for strengthening of existing preventive strategies against HCV and HIV infections such as screening of donor blood and safe injection practices in our locality.

7.
Environ Toxicol Chem ; 32(3): 569-76, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23258709

RESUMO

Temporal, biological, and environmental factors affecting accumulation of perfluoroalkyl substances (PFASs) are poorly understood in comparison with legacy lipid-soluble persistent organic pollutants. Temporal and biological comparisons of PFAS concentrations were made in great skuas (Stercorarius skua), a marine apex predator. Concentrations of 16 PFASs were quantified, including C4-C10 perfluorosulfonates (PFSAs), perfluorooctanesulfonamide (PFOSA), and C5-C14 perfluorocarboxylates (PFCAs). Concentrations of PFASs (ng/g wet wt) were significantly higher in eggs collected in Shetland in 2008 compared with 1980 for most compounds. However, the magnitude of the differences was small, with a mean increase of 3 ng/g. Levels of PFASs in great skuas were low compared with those of other seabirds in similar ecological niches; and in contrast to other contaminants measured in the same eggs, concentrations of PFASs did not correlate with trophic level. Concentrations of PFASs in adult plasma were significantly higher in males than in females for most PFASs. This suggests that maternal transfer through egg laying may be a significant mode of elimination of PFASs in female great skuas. The low concentrations of PFASs in eggs and plasma compared with other halogenated organic contaminants and other species suggest that great skuas do not bioaccumulate PFASs to the same extent as some other seabirds.


Assuntos
Charadriiformes/metabolismo , Poluentes Ambientais/metabolismo , Fluorcarbonetos/metabolismo , Óvulo/metabolismo , Animais , Monitoramento Ambiental , Feminino , Masculino , Sulfonamidas/metabolismo
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