Adequate levels of dietary sulphur amino acids impart improved liver and gut health in juvenile yellowtail kingfish (Seriola lalandi).

The sulphur amino acids methionine (Met) and cysteine (Cys) and their derivative taurine (Tau) are metabolically active molecules with interlinked roles in nutritional requirements. Deficiencies in these nutrients are linked to poor growth and health; however, the impacts of these deficiencies on organ structure and function are largely unknown. This study examined the effects of dietary Met, Cys and Tau fed at different levels on yellowtail kingfish (YTK) liver histology and surface colour, plasma biochemistry and posterior intestine histology. Samples were collected from two dose-response feeding trials that quantified (1) the Tau requirement and sparing effect of Met by feeding YTK diets containing one of seven levels of Tau at one of two levels of Met and (2) the Met requirement and sparing effect of Cys by feeding YTK diets containing one of five levels of Met at one of two levels of Cys. YTK fed inadequate levels of dietary Met, Cys and Tau exhibited thicker bile ducts, less red livers, more intestinal acidic goblet cell mucus and supranuclear vacuoles and less posterior intestinal absorptive surface area. Further, thicker bile ducts correlated with less red livers (a*, R), whereas increased hepatic fat correlated with a liver yellowing (b*). Our results indicate a shift towards histological properties and functions indicative of improved intrahepatic biliary condition, posterior intestinal nutrient absorption and homoeostasis of YTK fed adequate amounts of Met, Cys and Tau. These findings may assist in formulating aquafeed for optimised gastrointestinal and liver functions and maintaining good health in YTK.

Effects of dietary choline on liver lipid composition, liver histology and plasma biochemistry of juvenile yellowtail kingfish (Seriola lalandi).

Choline plays a crucial role in lipid metabolism for fish, and its deficiency in aquafeed has been linked to compromised health and growth performance. A 56-d experiment was conducted to examine the effects of dietary choline on lipid composition, histology and plasma biochemistry of yellowtail kingfish (Seriola lalandi; YTK; 156 g initial body weight). The dietary choline content ranged from 0·59 to 6·22 g/kg diet. 2-Amino-2-methyl-1-propanol (AMP) (3 g/kg) was added to diets, except for a control diet, to limit de novo choline synthesis. The results showed that the liver lipid content of YTK was similar among diets containing AMP and dominated by NEFA. In contrast, fish fed the control diet had significantly elevated liver TAG. Generally, the SFA, MUFA and PUFA content of liver lipid in fish fed diets containing AMP was not influenced by choline content. The SFA and MUFA content of liver lipid in fish fed the control diet was similar to other diets except for a decrease in PUFA. The linear relationship between lipid digestibility and plasma cholesterol was significant, otherwise most parameters were unaffected. When AMP is present, higher dietary choline reduced the severity of some hepatic lesions. The present study demonstrated that choline deficiency affects some plasma and liver histology parameters in juvenile YTK which might be useful fish health indicators. Importantly, the present study elucidated potential reasons for lower growth in choline-deficient YTK and increased the knowledge on choline metabolism in the fish.

Laser-heating system for high-pressure X-ray diffraction at the Extreme Conditions beamline I15 at Diamond Light Source.

In this article, the specification and application of the new double-sided YAG laser-heating system built on beamline I15 at Diamond Light Source are presented. This system, combined with diamond anvil cell and X-ray diffraction techniques, allows in situ and ex situ characterization of material properties at extremes of pressure and temperature. In order to demonstrate the reliability and stability of this experimental setup over a wide range of pressure and temperature, a case study was performed and the phase diagram of lead was investigated up to 80 GPa and 3300 K. The obtained results agree with previously published experimental and theoretical data, underlining the quality and reliability of the installed setup.

Time-Loss Injuries in Sub-Elite and Emerging Rugby League Players.

This study aimed to 1) investigate the incidence and characteristics of injuries in emerging rugby league players; and 2) explore the differences in injury incidence and characteristics between the various sub-elite competitions. An NRL emerging player development squad (n = 34) was observed from the beginning of pre-season until the finish of competition. Time-loss injury was defined as any physical pain or impairment sustained that resulted in players missing a match. Injuries were categorised according to circumstance, incidence, characteristics, playing position and competition level. Of a total of 196 injuries that were recorded, 45 were time-loss and 151 were transient. The total injury incidence was 7.9/1,000 playing hours. The most common sites for time-loss injuries were the shoulder, ankle/foot and knee. Ligament injuries accounted for the highest number of injuries by type. Forwards sustained the greatest number of injuries. However, backs suffered the greatest injury cost. The majority of time-loss injuries were sustained during competition matches. Injuries sustained during open age matches resulted in significantly higher injury cost to those received at NYC matches. NRL development and emerging rugby league players are exposed to high risk of injury. Lower limb and shoulder injuries to bone or connective tissue are prevalent as a result of contact during match play. Players at this developmental level feed into several different playing squads where disparities in physical development, maturation, playing intensity and training regimes are evident. This presents a challenge in matching physiological capabilities with playing demands for NRL development squads.

The application of evolutionary medicine principles for sustainable malaria control: a scoping study.

BACKGROUND: Current interventions against malaria have significantly reduced the number of people infected and the number of deaths. Concerns about emerging resistance of both mosquitoes and parasites to intervention have been raised, and questions remain about how best to generate wider knowledge of the underlying evolutionary processes. The pedagogical and research principles of evolutionary medicine may provide an answer to this problem. METHODS: Eight programme managers and five academic researchers were interviewed by telephone or videoconference to elicit their first-hand views and experiences of malaria control given that evolution is a constant threat to sustainable control. Interviewees were asked about their views on the relationship between practit groups and academics and for their thoughts on whether or not evolutionary medicine may provide a solution to reported tensions. RESULTS: There was broad agreement that evolution of both parasites and vectors presents an obstacle to sustainable control. It was also widely agreed that through more efficient monitoring, evolution could be widely monitored. Interviewees also expressed the view that even well planned interventions may fail if the evolutionary biology of the disease is not considered, potentially making current tools redundant. CONCLUSIONS: This scoping study suggests that it is important to make research, including evolutionary principles, available and easily applicable for programme managers and key decision-makers, including donors and politicians. The main conclusion is that sharing knowledge through the educational and research processes embedded within evolutionary medicine has potential to relieve tensions and facilitate sustainable control of malaria and other parasitic infections.

Commissioning services and Primary Health Networks.

Commissioning is set to become a stronger feature in the Australian health system as Primary Health Networks embrace it as a tool for improving population health outcomes. International experience shows that developing into a commissioning organisation is not always easy. Drawing on international experiences of commissioning, as well as those from the Australian hospital sector, will help smooth the path for Primary Health Networks.

A migrant study of pubertal timing and tempo in British-Bangladeshi girls at varying risk for breast cancer.

INTRODUCTION: Earlier menarche is related to subsequent breast cancer risk, yet international differences in the age and tempo of other pubertal milestones and their relationships with body mass index (BMI) are not firmly established in populations at differing risk for breast cancer. We compared age and tempo of adrenarche, thelarche, pubarche, and menarche in a migrant study of Bangladeshi girls to the United Kingdom (UK) and assessed whether differences by migration were explained by differences in BMI. METHODS: Included were groups of Bangladeshi (n =168), British-Bangladeshi (n =174) and white British (n =54) girls, aged 5 to 16 years. Interviewer-administered questionnaires obtained pubertal staging; height and weight were measured. Salivary dehydroepiandrosterone-sulfate concentrations >400 pg/ml defined adrenarche. Median ages of pubertal milestones and hazard ratios (HR) with 95% confidence intervals (CI) were estimated from Weibull survival models. RESULTS: In all three groups, adrenarche occurred earliest, followed by thelarche, pubarche, and finally menarche. Neither median age at adrenarche (Bangladeshi = 7.2, British-Bangladeshi = 7.4, white British = 7.1; P-trend = 0.70) nor at menarche (Bangladeshi = 12.5, British-Bangladeshi = 12.1, white British = 12.6; P-trend = 0.70) differed across groups. In contrast, median age at thelarche (Bangladeshi = 10.7, British-Bangladeshi = 9.6, white British = 8.7; P-trend <0.01) occurred earlier among girls living in the UK. Compared with Bangladeshi girls, HRs (95% CI) for earlier thelarche were 1.6 (1.1 to 2.4) for British-Bangladeshi girls and 2.6 (1.5 to 4.4) for white British girls (P-trend <0.01), but were attenuated after adjustment for BMI (British-Bangladeshi = 1.1 (0.7 to 1.8), white British = 1.7(1.0 to 3.1); P-trend =0.20). CONCLUSIONS: Thelarche occurred earlier, but puberty progressed slower with increasing exposure to the UK environment; differences were partially explained by greater BMI. The growth environment might account for much of the ethnic differences in pubertal development observed across and within countries.

Long-term effectiveness of first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy in Ghana.

OBJECTIVES: Information on the long-term effectiveness and tolerability of efavirenz- or nevirapine-based antiretroviral therapy (ART) in Africa is lacking. The primary objective of this retrospective observational study was to compare the long-term clinical and immunological outcomes of efavirenz- versus nevirapine-based first-line ART in a large government clinic in Ghana. PATIENTS AND METHODS: The main outcomes were AIDS, death, ART-related toxicity, discontinuation of ART and a composite endpoint of death, AIDS or ART discontinuation. These time-to-event outcomes were compared using a Cox proportional hazards regression model. CD4 counts on ART were compared using a mixed-effects model. RESULTS: A total of 3990 patients started non-nucleoside reverse transcriptase inhibitor (NNRTI)-based ART between 2004 and 2010, of which 2369 (59%) were on efavirenz. No significant differences were apparent between each NNRTI for subsequent risk of AIDS, death or the composite of treatment failure; however, stavudine use was independently associated with an increased risk of death [adjusted hazard ratio (HR) 1.60 (95% CI: 1.21-2.11)]. There was an increased risk of early toxicity with nevirapine leading to discontinuation [adjusted HR 1.53 (95% CI: 1.23-1.97)], mostly due to excess skin rashes in the first 2 months of treatment; however, overall discontinuation rates were low. CONCLUSIONS: There was no difference in the long-term effectiveness of efavirenz- and nevirapine-based ART in this population; however, patients initiating nevirapine were more likely to develop early toxicity and discontinue this drug. The excess mortality observed in patients taking stavudine is of concern and should prompt increased efforts to replace it with alternative antiretroviral drugs in developing countries.

Atacama Large Aperture Submillimeter Telescope (AtLAST) science: Planetary and cometary atmospheres.

The study of planets and small bodies within our Solar System is fundamental for understanding the formation and evolution of the Earth and other planets. Compositional and meteorological studies of the giant planets provide a foundation for understanding the nature of the most commonly observed exoplanets, while spectroscopic observations of the atmospheres of terrestrial planets, moons, and comets provide insights into the past and present-day habitability of planetary environments, and the availability of the chemical ingredients for life. While prior and existing (sub)millimeter observations have led to major advances in these areas, progress is hindered by limitations in the dynamic range, spatial and temporal coverage, as well as sensitivity of existing telescopes and interferometers. Here, we summarize some of the key planetary science use cases that factor into the design of the Atacama Large Aperture Submillimeter Telescope (AtLAST), a proposed 50-m class single dish facility: (1) to more fully characterize planetary wind fields and atmospheric thermal structures, (2) to measure the compositions of icy moon atmospheres and plumes, (3) to obtain detections of new, astrobiologically relevant gases and perform isotopic surveys of comets, and (4) to perform synergistic, temporally-resolved measurements in support of dedicated interplanetary space missions. The improved spatial coverage (several arcminutes), resolution (~ 1.2'' - 12''), bandwidth (several tens of GHz), dynamic range (~ 10 5) and sensitivity (~ 1 mK km s -1) required by these science cases would enable new insights into the chemistry and physics of planetary environments, the origins of prebiotic molecules and the habitability of planetary systems in general.

Our present understanding of what planets and comets are made of, and how their atmospheres move and change, has been greatly influenced by observations using existing and prior telescopes operating at wavelengths in the millimeter/submillimeter range (between the radio and infrared parts of the electromagnetic spectrum), yet major gaps exist in our knowledge of these diverse phenomena. Here, we describe the need for a new telescope capable of simultaneously observing features on very large and very small scales, and covering a very large spread of intrinsic brightness, in planets and comets. Such a telescope is required for mapping storms on giant planets, measuring the compositions of the atmospheres and plumes of icy moons, detecting new molecules in comets and planetary atmospheres, and to act as a complement for measurements by current and future interplanetary spacecraft missions. We discuss the limitations of currently-available millimeter/submillimeter telescopes, and summarize the requirements and applications of a new and larger, more sensitive facility operating at these wavelengths: the Atacama Large Aperture Submillimeter Telescope (AtLAST).

Atacama Large Aperture Submillimeter Telescope (AtLAST) science: Surveying the distant Universe.

During the most active period of star formation in galaxies, which occurs in the redshift range 1 < z < 3, strong bursts of star formation result in significant quantities of dust, which obscures new stars being formed as their UV/optical light is absorbed and then re-emitted in the infrared, which redshifts into the mm/sub-mm bands for these early times. To get a complete picture of the high- z galaxy population, we need to survey a large patch of the sky in the sub-mm with sufficient angular resolution to resolve all galaxies, but we also need the depth to fully sample their cosmic evolution, and therefore obtain their redshifts using direct mm spectroscopy with a very wide frequency coverage. This requires a large single-dish sub-mm telescope with fast mapping speeds at high sensitivity and angular resolution, a large bandwidth with good spectral resolution and multiplex spectroscopic capabilities. The proposed 50-m Atacama Large Aperture Submillimeter Telescope (AtLAST) will deliver these specifications. We discuss how AtLAST allows us to study the whole population of high-z galaxies, including the dusty star-forming ones which can only be detected and studied in the sub-mm, and obtain a wealth of information for each of these up to z ∼ 7: gas content, cooling budget, star formation rate, dust mass, and dust temperature. We present worked examples of surveys that AtLAST can perform, both deep and wide, and also focused on galaxies in proto-clusters. In addition we show how such surveys with AtLAST can measure the growth rate f σ 8 and the Hubble constant with high accuracy, and demonstrate the power of the line-intensity mapping method in the mm/sub-mm wavebands to constrain the cosmic expansion history at high redshifts, as good examples of what can uniquely be done by AtLAST in this research field.

Galaxies come in a wide variety of shapes, sizes, and colours, despite all of them having originated from similar initial conditions in the early Universe. Understanding this diversity by tracing back the evolutionary pathways of different types of galaxies is a major endeavour in modern astrophysics. Galaxies build their stellar mass over time by converting gas into stars through various episodes of star formation. Understanding exactly when, where, and how this star formation process is triggered or suppressed is therefore a crucial question to answer. Current observations reveal that the Universe was at its most active (in terms of star formation rate per unit volume) in the distant past, about 10 billion years ago. By measuring the amount of gas and dust in galaxies at that epoch, we also know that the reason for this very high star formation activity is large reservoirs of gas (the fuel for star formation) and the higher efficiency of galaxies at converting their gas into stars. However, recent work also reveals that we are missing significant numbers of distant actively star-forming galaxies in current samples because these are obscured by dust, and therefore our picture is still very incomplete. In this paper, we explore how a new proposed telescope, the Atacama Large Aperture Submillimeter Telescope (AtLAST: http://atlast-telescope.org), can provide us with the very important missing pieces of this puzzle. AtLAST will allow us to map large areas of the sky at unprecedented depth, resolution and multiplex spectroscopic capabilities. This telecope would provide us with a complete, homogeneous and unbiased picture of the star-forming galaxy population in the early Universe. Not only will we be able to discover these galaxies, but also measure their distances, the composition of their gas and dust content, and the rate at which they convert gas into stars.

Atacama Large Aperture Submillimeter Telescope (AtLAST) science: Our Galaxy.

As we learn more about the multi-scale interstellar medium (ISM) of our Galaxy, we develop a greater understanding for the complex relationships between the large-scale diffuse gas and dust in Giant Molecular Clouds (GMCs), how it moves, how it is affected by the nearby massive stars, and which portions of those GMCs eventually collapse into star forming regions. The complex interactions of those gas, dust and stellar populations form what has come to be known as the ecology of our Galaxy. Because we are deeply embedded in the plane of our Galaxy, it takes up a significant fraction of the sky, with complex dust lanes scattered throughout the optically recognizable bands of the Milky Way. These bands become bright at (sub-)millimetre wavelengths, where we can study dust thermal emission and the chemical and kinematic signatures of the gas. To properly study such large-scale environments, requires deep, large area surveys that are not possible with current facilities. Moreover, where stars form, so too do planetary systems, growing from the dust and gas in circumstellar discs, to planets and planetesimal belts. Understanding the evolution of these belts requires deep imaging capable of studying belts around young stellar objects to Kuiper belt analogues around the nearest stars. Here we present a plan for observing the Galactic Plane and circumstellar environments to quantify the physical structure, the magnetic fields, the dynamics, chemistry, star formation, and planetary system evolution of the galaxy in which we live with AtLAST; a concept for a new, 50m single-dish sub-mm telescope with a large field of view which is the only type of facility that will allow us to observe our Galaxy deeply and widely enough to make a leap forward in our understanding of our local ecology.

There are many individual components contributing to the overall evolution of our Galaxy, the Milky Way. Through understanding the physics and chemistry of the Galaxy around us, we better understand our origins, our environment, and where we're going. Here we outline a number of observational surveys of our Galaxy that would produce a step change in our understanding of the evolution of the Galaxy around us, both as a template for others, and as the only way of understanding our place in the larger Universe. We present surveys of the Galactic Plane focusing on the dust and magnetic fields, chemistry, and dynamics of the gas. We then suggest surveys of local stars and star forming regions to uncover the origins of stars, planets and how those planetary systems evolve over the course of their lives, helping to put our Sun and Solar System in context. These types of observations require simultaneously sensitive, long wavelength (between 0.3 and 3 millimetre) observations as well as a large coverage of the sky, and cannot be done with current observatories operating at these wavelengths. Future leaps in understanding these systems will require a new telescope; a large telescope at a good observing location with a large field of view. This telescope, the Atacama Large Sub-mm Telescope (AtLAST; http://atlast-telescope.org/) is being developed, and here we are presenting the science cases for this new telescope from the point of view of our Galaxy. Together, these studies will revolutionise our understanding of the history and evolution of our Galaxy and bring us yet another step closer to understanding our place in, and the evolution of, our Universe.

Science development study for the Atacama Large Aperture Submillimeter Telescope (AtLAST): Solar and stellar observations.

Observations at (sub-)millimeter wavelengths offer a complementary perspective on our Sun and other stars, offering significant insights into both the thermal and magnetic composition of their chromospheres. Despite the fundamental progress in (sub-)millimeter observations of the Sun, some important aspects require diagnostic capabilities that are not offered by existing observatories. In particular, simultaneously observations of the radiation continuum across an extended frequency range would facilitate the mapping of different layers and thus ultimately the 3D structure of the solar atmosphere. Mapping large regions on the Sun or even the whole solar disk at a very high temporal cadence would be crucial for systematically detecting and following the temporal evolution of flares, while synoptic observations, i.e., daily maps, over periods of years would provide an unprecedented view of the solar activity cycle in this wavelength regime. As our Sun is a fundamental reference for studying the atmospheres of active main sequence stars, observing the Sun and other stars with the same instrument would unlock the enormous diagnostic potential for understanding stellar activity and its impact on exoplanets. The Atacama Large Aperture Submillimeter Telescope (AtLAST), a single-dish telescope with 50m aperture proposed to be built in the Atacama desert in Chile, would be able to provide these observational capabilities. Equipped with a large number of detector elements for probing the radiation continuum across a wide frequency range, AtLAST would address a wide range of scientific topics including the thermal structure and heating of the solar chromosphere, flares and prominences, and the solar activity cycle. In this white paper, the key science cases and their technical requirements for AtLAST are discussed.

Observations of our Sun and other stars at wavelengths of around one millimeter, i.e. in the range between infrared and radio waves, present a valuable complementary perspective. Despite significant technological advancements, certain critical aspects necessitate diagnostic capabilities not offered by current observatories. The proposed Atacama Large Aperture Submillimeter Telescope (AtLAST), featuring a 50-meter aperture and slated for construction at a high altitude in Chile's Atacama desert, promises to address these observational needs. Equipped with novel detectors that would cover a wide frequency range, AtLAST could unlock a plethora of scientific studies contributing to a better understanding of our host star. Simultaneous observations over a broad frequency range at rapid succession would enable the imaging of different layers of the Sun, thus elucidating the three-dimensional thermal and magnetic structure of the solar atmosphere and providing important clues for many long-standing central questions such as how the outermost layers of the Sun are heated to very high temperatures, the nature of large-scale structures like prominences, and how flares and coronal mass ejections, i.e. enormous eruptions, are produced. The latter is of particular interest to modern society due to the potentially devastating impact on the technological infrastructure we depend on today. Another unique possibility would be to study the Sun's long-term evolution in this wavelength range, which would yield important insights into its activity cycle. Moreover, the Sun serves as a fundamental reference for other stars as, due to its proximity, it is the only star that can be investigated in such detail. The results for the Sun would therefore have direct implications for understanding other stars and their impact on exoplanets. This article outlines the key scientific objectives and technical requirements for solar observations with AtLAST.

Climate change, malaria and neglected tropical diseases: a scoping review.

To explore the effects of climate change on malaria and 20 neglected tropical diseases (NTDs), and potential effect amelioration through mitigation and adaptation, we searched for papers published from January 2010 to October 2023. We descriptively synthesised extracted data. We analysed numbers of papers meeting our inclusion criteria by country and national disease burden, healthcare access and quality index (HAQI), as well as by climate vulnerability score. From 42 693 retrieved records, 1543 full-text papers were assessed. Of 511 papers meeting the inclusion criteria, 185 studied malaria, 181 dengue and chikungunya and 53 leishmaniasis; other NTDs were relatively understudied. Mitigation was considered in 174 papers (34%) and adaption strategies in 24 (5%). Amplitude and direction of effects of climate change on malaria and NTDs are likely to vary by disease and location, be non-linear and evolve over time. Available analyses do not allow confident prediction of the overall global impact of climate change on these diseases. For dengue and chikungunya and the group of non-vector-borne NTDs, the literature privileged consideration of current low-burden countries with a high HAQI. No leishmaniasis papers considered outcomes in East Africa. Comprehensive, collaborative and standardised modelling efforts are needed to better understand how climate change will directly and indirectly affect malaria and NTDs.

Guidelines to Establish an Equitable Mobile Health Ecosystem.

Mobile health (mHealth)-that is, use of mobile devices, such as mobile phones, monitoring devices, personal digital assistants, and other wireless devices, in medical care-is a promising approach to the provision of support services. mHealth may aid in facilitating monitoring of mental health conditions, offering peer support, providing psychoeducation (i.e., information about mental health conditions), and delivering evidence-based practices. However, some groups may fail to benefit from mHealth despite a high need for mental health services, including people from racially and ethnically disadvantaged groups, rural residents, individuals who are socioeconomically disadvantaged, and people with disabilities. A well-designed mHealth ecosystem that considers multiple elements of design, development, and implementation can afford disadvantaged populations the opportunity to address inequities and facilitate access to and uptake of mHealth. This article proposes inclusion of the following principles and standards in the development of an mHealth ecosystem of equity: use a human-centered design, reduce bias in machine-learning analytical techniques, promote inclusivity via mHealth design features, facilitate informed decision making in technology selection, embrace adaptive technology, promote digital literacy through mHealth by teaching patients how to use the technology, and facilitate access to mHealth to improve health outcomes.

Progress in paediatric parasitology: a preface to a topic focusing on ever younger subjects.

Without realizing it perhaps, the research activities of many parasitologists are often focused upon the study of parasites most commonly found in children. Though there is little recognition of paediatric parasitology as a separate topic within medical parasitology, with the global interest in promotion of maternal and child health, alleviation of diseases associated with poverty and requirements of 'child-sized' medicines, a more formal consideration is now timely. Recent research, for example, has highlighted that defining precisely the 'first-age' at which parasites interfere with a child's health, or normal developmental processes, is being revised. Attention is now drawn towards ever younger subjects, for parasites have the capacity to also influence the health of the foetus within the in utero environment, altering immune-development. These subtle, yet evolutionary profound interactions perhaps manifest themselves as to why some children are more prone to infection(s), develop overt disease and sadly die while others do not. Here, we address the growing importance of paediatric parasitology and its applications within disease control strategies as highlighted in the 2010 Autumn Symposium of the British Society of Parasitology.

Understanding ethnic differences in behaviour relating to Schistosoma mansoni re-infection after mass treatment.

It is now widely recognized that a decentralized approach to the control of parasitic infections in rural sub-Saharan populations allows for the design of more effective control programmes and encourages high compliance. Compliance is usually an indicator of treatment success, but cannot be used as a measure of long-term benefit since re-infection will be strongly influenced by a number of factors including the social ecology of a community. In this paper qualitative and quantitative methods are used to identify and understand the structural and behavioural constraints that may influence water contact behaviour and create inequalities with respect to Schistosoma re-infection following anti-helminth drug treatment. The research is set in a community where participant engagement has remained uniformly high throughout the course of a 10-year multidisciplinary study on treatment and re-infection, but where levels of re-infection have not been uniform and, because of variations in water contact behaviour, have varied by age, sex and ethnic background. Variations in the biomedical knowledge of schistosomiasis, socioeconomic constraints and ethnic differences in general attitudes towards life and health are identified that may account for some of these behavioural differences. The observations highlight the benefits of understanding the socio-ecology of control and research settings at several levels (both between and within ethnic groups); this will help to design more effective and universally beneficial interventions for control and help to interpret research findings.

A purple patch for evidence-based health policy?

The global focus on nation states' responses to the COVID-19 pandemic has rightly highlighted the importance of science and evidence as the basis for policy action. Those with a lifelong passion for evidence-based policy (EBP) have lauded Australia's and other nations' policy responses to COVID-19 as a breakthrough moment for the cause. This article reflects on the complexity of the public policy process, the perspectives of its various actors, and draws on Alford's work on the Blue, Red and Purple zones to propose a more nuanced approach to advocacy for EBP in health. We contend that the pathway for translation of research evidence into routine clinical practice is relatively linear, in contrast to the more complex course for translation of evidence to public policy - much to the frustration of health researchers and EBP advocates. Cairney's description of the characteristics of successful policy entrepreneurs offers useful guidance to advance EBP and we conclude with proposing some practical mechanisms to support it. Finally, we recommend that researchers and policy makers spend more time in the Purple zone to enable a deeper understanding of, and mutual respect for, the unique contributions made by research, policy and political actors to sound public policy.