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Vulnerability of marine megafauna to global at‐sea anthropogenic threats
Get PDFMarine megafauna species are affected by a wide range of anthropogenic threats. To evaluate the risk of such threats, species’ vulnerability to each threat must first be determined. We build on the existing threats classification scheme and ranking system of the International Union for Conservation of Nature (IUCN) Red List of Threatened Species by assessing the vulnerability of 256 marine megafauna species to 23 at-sea threats. The threats we considered included individual fishing gear types, climate-change-related subthreats not previously assessed, and threats associated with coastal impacts and maritime disturbances. Our ratings resulted in 70 species having high vulnerability (v > 0.778 out of 1) to at least 1 threat, primarily drifting longlines, temperature extremes, or fixed gear. These 3 threats were also considered to have the most severe effects (i.e., steepest population declines). Overall, temperature extremes and plastics and other solid waste were rated as affecting the largest proportion of populations. Penguins, pinnipeds, and polar bears had the highest vulnerability to temperature extremes. Bony fishes had the highest vulnerability to drifting longlines and plastics and other solid waste; pelagic cetaceans to 4 maritime disturbance threats; elasmobranchs to 5 fishing threats; and flying birds to drifting longlines and 2 maritime disturbance threats. Sirenians and turtles had the highest vulnerability to at least one threat from all 4 categories. Despite not necessarily having severe effects for most taxonomic groups, temperature extremes were rated among the top threats for all taxa except bony fishes. The vulnerability scores we provide are an important first step in estimating the risk of threats to marine megafauna. Importantly, they help differentiate scope from severity, which is key to identifying threats that should be prioritized for mitigation
New graduate medication safety preparedness: an Australian cross-sectional and longitudinal qualitative research study
Get PDFIntroduction: Patient safety is paramount, yet medication management errors are common, including amongst new graduates. Ongoing need exists to examine new graduates’ medication safety preparedness, to better improve preparedness and help them manage medication errors. This cross-sectional and longitudinal qualitative research (LQR) explores new graduates’ medication safety preparedness in nursing, pharmacy and medicine.Methods: Underpinned by social constructionism, 26 final-year healthcare students at an Australian university participated in three study phases between July 2019 and April 2020: entrance interviews (around degree completion), longitudinal audio-diaries (through approximately the first 12 weeks of work), and exit interviews (after approximately 12 weeks of work). We analyzed interview and audio-diary transcripts, and audio-diary email correspondence using team-based framework analysis, cross-sectionally and longitudinally.Results: Participants’ medication safety stories demonstrated mostly unpreparedness, often about developing and implementing medication therapy plans. Medication error narratives revealed errors (of commission or omission) made by new graduates or others. They were rich in emotional talk (mostly negative such as anxiety, anger and sadness talk), illustrating psychosocial impacts on new graduates. However, positive emotional talk was also present in preparedness stories. While the proportion of preparedness stories increased across time at the cohort level, we found more nuanced/complex patterning in participants’ narratives at the individual level including evidence of stability, and positive or negative changes in medication safety preparedness.Discussion: We offer evidence-based recommendations for student/new graduate learning to help educators better prepare them for medication safety and enable them to cope with the emotional work of safe medication management. Further LQR with longer study durations is now needed on medication safety preparedness
Children With Biliary Atresia Have Substantial Morbidity in Early Childhood and a High Risk of Liver Transplantation
Get PDFBackgroundBiliary atresia is a rare but severe congenital anomaly associated with substantial morbidity and mortality in early childhood. Population-based estimates of survival, surgical management, and liver transplantation across Europe remain limited. This study aimed to describe mortality and morbidity among children born with biliary atresia using multinational population-based data.MethodsWe investigated children diagnosed with biliary atresia across nine registries from five countries within the European surveillance of congenital anomalies network (EUROCAT), covering births from 1995 to 2014. The data were linked to hospital databases and adjusted for regional differences and follow-up length.ResultsOur cohort included 171 children, with an infant mortality rate of 12.3% (95% CI: 7.8–17.6) and a mortality rate before age five of 18.5% (95% CI: 10.7–27.7). Among these children, 151 had undergone surgery, including 133 who received the Kasai procedure by the age of 1 year at a median age of 57 days (95% CI: 51–62 days). By age five, 37% (adjusted percentage, 95% CI: 30–44) had undergone liver transplantation, with the median age at transplantation being 318 days (95% CI: 244–391 days). Median age at death in the first year was over 6 months and was not immediately after surgery.ConclusionThe high mortality and the substantial need for liver transplantation within the first year of life underline the severity of biliary atresia. This highlights the urgent need for further research into pregnancy exposures that may contribute to this rare but severe congenital anomaly to develop primary prevention strategies
The Desirable Health Indicator: A New Indicator of Population Health and Healthcare Utilisation
Get PDFBackground and ObjectiveHealthcare research faces challenges in developing metrics that resonate with the general public or policymakers. We created a Desirable Health Indicator (DHI) to address this gap, centred around New Year's wishes for survival and non-occurrence of undesired events in the following year, for the population of Wales, UK, following discussions with policymakers and members of the public.MethodsWe created retrospective, population-based individual-level cohorts from linked routinely collected anonymised, health and demographic data from the Secure Anonymised Information Linkage (SAIL) Databank (2015-2022). The DHI was calculated per person per year and quantified the distribution of the population who survive calendar years and do not use selected health services (not admitted to hospital; no emergency department attendance; and not prescribed medication used in infection, analgesics, or mental health drugs). Group and individual interviews were held with members of the public and policy makers seeking their views of the indicator.ResultsThe findings were understood and well received by members of the general public and policymakers. Between 2015 and 2019, the percentage of individuals meeting the DHI ranged between 39.6%-41.9%, increasing to 48.6% and 46.2% for2020 and 2021respectively, and reducing to 43.1% in 2022. Focussing on the year 2022, 1,154,630 (43.1%) met the DHI from a population of 2,677,829. The percentage of people with desirable health decreased significantly with age and with increasing socioeconomic deprivation. A higher proportion of males (49.2%) met the DHI compared to females (37.1%). Being male (aOR = 1.62 [95%CI 1.61,1.63]), 10-19 years of age (aOR = 1.69 [95%CI 1.68,1.71]), and living in the least deprived areas of Wales (aOR = 1.31 [95%CI 1.30,1.32]) were the characteristics associated with the highest odds of meeting the desirable health indicator. The most prevalent reasons for not meeting the indicator were GP prescriptions for drugs used in infections (29.5%), analgesics (22.8%) and mental health conditions (20.2%).ConclusionThe DHI provides an insightful and novel tool for monitoring aspects of population health and healthcare utilisation. The DHI's coverage of important topics, derived from routine data sources, makes it a reproducible, temporally flexible, and easily understood indicator, suitable for informing policy development and addressing aspects of health inequalities. As data linkage capabilities expand internationally there are opportunities for implementation to aid comparison and better understanding of how systems perform
The behavioural, toxicological, and biochemical effects of caffeine on Lumbriculus variegatus
No full textLumbriculus variegatus is increasingly used in environmental toxicology and pharmacology, yet the behavioural, toxicological and biochemical effects of caffeine in this species remain poorly defined. Here, we characterised caffeine’s effects on stimulated behaviours, locomotor activity, toxicity, and energy stores. Exposure to ≥5.0 mM caffeine for 10 minutes or ≥3.0 mM for 24 hours significantly reduced stimulated behaviours, with locomotor activity similarly suppressed at ≥5.0 mM (10 minutes) and ≥1.0 mM (24 hours) (p < .05, n = 8) with impairment persisting 24 hours after exposure to 10 mM (10 minutes) or 3.5 mM (24 hours). A 24-hour LC50 of 4.7 mM (95% CI: 4.60–4.70 mM) was observed, with significant lethality after seven days at 4.5 mM (p < .0001). These findings provide the first characterisation of caffeine’s behavioural and toxicological effects in L. variegatus and contribute to the environmental risk assessment of caffeine contamination in freshwater systems
A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
No full textImproving population well-being is increasingly recognized as a global priority, yet evidence on the comparative effectiveness of well-being-focused interventions in adults is fragmented. Here we conduct a preregistered systematic review and network meta-analysis (PROSPERO CRD42023403480) of randomized controlled trials evaluating well-being interventions in adults without diagnosed conditions. Searches of MEDLINE, PsycINFO, CENTRAL and Scopus (to March 2023) identified 183 trials (n = 22,811). Interventions included mindfulness-based, compassion-based, acceptance and commitment therapy and positive psychology interventions, as well as exercise, yoga, educational, nature-based programmes and combined exercise-psychological approaches. Risk of bias was assessed using RoB 2, and data were synthesized using random-effects network meta-analysis. Most interventions improved well-being compared with inactive controls. Combined exercise-psychological interventions produced the largest effect (standardized mean difference of 0.73, 95% confidence interval 0.27 to 1.20). Mindfulness, compassion, single positive psychology, yoga and exercise interventions demonstrated moderate, consistent effects (standardized mean difference of 0.41–0.49), with no significant differences between interventions. Nature-based interventions were not significantly more effective than controls, but evidence was limited by conceptual and methodological heterogeneity. Risk of bias was frequently moderate to high, and funnel plot asymmetry suggested potential publication bias. However, multiple sensitivity analyses (including grey literature, excluding studies with high risk of bias and small studies) supported the robustness of overall conclusions. Most comparisons (71%) were rated as moderate in certainty of evidence using CINEMA. These findings provide an integrated synthesis of the well-being intervention literature and highlight priority areas for future interdisciplinary, methodologically robust research. No external funding was received
Design and testing of a universal platform for search and rescue operation: Exploring indoor and outdoor potentials
No full textLarge-scale natural and human-caused disasters have created significant challenges for worldwide Search and Rescue (SAR) operations, highlighting persisting concerns related to the efficiency and technical limitations of existing technologies. To address these challenges, the proposed Universal Platform for Search and Rescue integrates various technologies, including a voice-guided control system, advanced 3D reconstruction techniques, and a people tracker and follower system. A central feature of our work is the platform’s universality: our system acts as an additional, modular controller that can connect to any robotic platform—commercial or custom—that supports text-based command communication via network or cable. The system does not replace original robot logic, but rather extends capabilities with minimal integration. Tests showed that the platform can effectively execute voice commands and track a specified route even in high-wind (23 km/h) and noisy environments (70–100 dB for the Drone, 65–99.6 dB for the Quadruped), providing a user-friendly and intuitive interaction for users across different skill levels. Performance metrics indicated strong quality in 3D scene reconstruction with significant similarity between the reconstructed images and reference images (Drone: indoor: 0.82 SSIM, outdoor: 0.81 SSIM; Quadruped: indoor: 0.79 SSIM, outdoor: 0.58 SSIM). Consequently, the immersive 3D mapping reconstruction facilitated prompt and precise terrain assessments for both internal and external operations. Furthermore, the integration of real-time video streaming and cloud-based connectivity optimized the data flow and strengthened communication during operations, allowing person face identification, 3D tracking, and following
Exploring recovery from anorexia in autistic adults: a qualitative study
Get PDFObjectives: To examine the barriers and facilitators of anorexia nervosa (AN) recovery in adults with autism. Design: Qualitative study using semi-structured interviews with autistic adults who identified as being in recovery or having recovered from AN. Setting: Participants were recruited via advertisements on social media and an eating disorder (ED) forum. Online Zoom interviews with 12 participants were conducted from October to November 2023. Participants: Overall, 12 autistic adults who identified as being in recovery or recovered from AN were included (11 women and 1 man; aged between 18–50 years). Results: Four key themes were identified: ‘Sensory Experiences’, ‘Recovery in progress’, ‘Changing to healthy mindsets’ and ‘Engaging with treatment’. Results indicated that recovery for participants did not follow a linear path, with the role of autistic traits, such as sensory sensitivities, interoception and the internal voice, making recovery challenging. Conclusion: This study provides insight into the challenges and motivations experienced during the recovery process. Findings highlight the need for further research to improve guidelines and autism awareness in ED services
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