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The current study, which expects to fill in the gap in research on transgender sex workers in India, examines the sexual identity negotiation, risk perception and condom compliance, sexual health screening and testing behavior, contextual barriers to healthcare seeking, and barriers to community mobilization among this population. The study was conducted in the red-light districts of Kolkata and rural subdivisions of West Bengal, and Eastern India. Transgender sex workers comprise 15% of the sex workers’ populace in India, yet they are an understudied and underserved group in the commercial sex sector. It is anticipated that the study will help to formulate future programmatic interventions that can cater more effectively to the health needs of Indian transgender commercial sex workers, contribute to the HIV/STI risk reduction among this group, and reduce barriers to attaining health.

Background: Candida auris has been associated with rapid transmission and high mortality. A novel PCR based surveillance programme was initiated at a London teaching hospital from January 2018. The results of this implementation until March 2019 are presented along with the clinical, transmission and phylogenetic characteristics encountered in that setting. Methods: A real time-PCR assay for C auris was developed, validated, and implemented for direct use on skin swabs and urine. Environmental swabs were also tested by PCR as an emergency outbreak control measure. Clinical risk factors and outcomes of patients were determined. Environmental dispersal was assessed using 24 h settle plate cultures around 9 colonised patients followed by air sampling around one colonised patient during high and low turbulence activities. Sequencing was performed using Illumina HiSeq and maximum likelihood phylogenies were constructed using rapid bootstrap analysis. Results 21 C. auris colonised patients were identified. Median turnaround time of colonisation detection reduced from 141 h (5.8 d) to approximately 24 h enabling rapid infection control precautions. Settle plates detected 70 to 600 CFU/m2 around colonised patients over 24 h and air sampling suggested dispersal during turbulent activities. C. auris DNA was detected from 35.7% environmental swabs. Despite being in a high-risk setting, no patients developed invasive infection. Sequencing analysis of isolates from this centre identified two introductions of the South Asian (Clade I) and one of the South African (Clade III) strain. Conclusion: The PCR offers a rapid, scalable method of screening and supports clinical risk reduction in settings likely to encounter multiple introductions.

This study was conducted in the Amuria district of Northeastern Uganda. The aim of the study was to assessthe performance of Community Based Disaster Risk Reduction (CMDRR) approach in mitigating disastereffects in the area. The objectives were to assess the effectiveness of community preparedness, response, andrecovery efforts in mitigating disasters in the study area. Aberilela and Wera sub-counties were purposivelyselected, and two parishes were chosen from each of the two sub counties based on their vulnerability to flooddisasters. A sample of 300 household heads were randomly selected. Methods of data collection includedquestionnaires, in-depth interviews with key informants, focus group discussions, observation, and documentsreview. The collected data were analysed using descriptive statistics and triangulated with thematic analysisof the data from interviews and field observations. Results from the study indicate that the CMDRR approachhad performed well despite some shortcomings. The approach had been able to prepare the community bytraining them in disaster management activities, developing hazard prone maps, disaster plans, establishedeffective rescue measures and other response measures for the affected communities. However, it had failedin building capacity among the communities to stock essential services including food, early warning systemsand in detecting and predicting disaster as well as building gender and age balanced capacity in thecommunities. Overall, the performance of CMDRR committees in Amurai and particularly Abarilela andWera sub-counties was above average. The study recommends that government should adopt this approachand replicate it in other disaster-prone areas for effective disaster management.

This research aims to investigate the impact of three different training methods (digital game, drill, and traditional education) on the motivation of the students to teach earthquake preparedness and earthquake prevention knowledge to primary school students. The explanatory design from the mixed-methods research was used in the study. The sample of the study consists of 294 students at the fourth-grade level in three different elementary schools in one of Turkey’s easternmost provinces. At the end of different educational methods, the motivation scale about the course was used to determine the motivations of the students. Focus group interviews were conducted with students randomly selected from each study group to examine in depth the reasons for the differentiation of motivation levels of the students. The findings showed that students who participated in the traditional education method were more motivated than the other methods of teaching. Besides, students who study with the digital game were found to be less motivated. In this study, the limitations and advantages of educational methods in terms of motivation were examined in-depth, and the reasons affecting motivation were discussed. The results can provide important insights to educators, educational game designers, and educational politicians.

Our objective is to define a standard protocol for post-partum salpingectomy and provide a prospective assessment of safety and feasibility of such a procedure. Thus, a protocol for performing post-partum salpingectomy in limited-resource environments was created based on contemporary practices for tubal ligation. Gravidae presenting for post-partum tubal ligation following vaginal delivery or at time of cesarean were prospectively approached and, if consent was obtained, enrolled. Outcomes were compared to a historical cohort of gravidae who underwent standard post-partum tubal ligation following vaginal birth or at the time of cesarean as per institutional standard of care. The primary outcome was operative time. One hundred and fifty-seven subjects underwent post-partum salpingectomy following cesarean or vaginal delivery (on post-partum days 0–2). Post-partum salpingectomy performed after vaginal delivery (n = 97) resulted in slightly longer operative times (39.1 ± 11.8 vs. 34.3 ± 13.1 min, p = 0.003) and slightly greater blood loss (21.0 ± 22.0 vs. 13.4 ± 17.3 mL, p = 0.001) than modified Pomeroy tubal ligation (n = 200). Post-partum salpingectomy at cesarean resulted in no difference in estimated blood loss, but slightly longer operative times compared to Parkland tubal ligations (99.5 ± 47.3 vs. 86.5 ± 33.9 min, p = 0.048). Surgical complications for post-partum salpingectomy were similar to controls, regardless of when the procedure was performed. In conclusion, a standardized protocol created for post-partum salpingectomy using suture ligation is feasible and safe.

Plan du chapitre : 1- Introduction ; 2- Localized disasters dealt with internationally ; 3- Disaster science: a naturalistic framework ; 4- Understanding nature in disasters ; 5- Denaturalizing disasters or the arrival of reflexivity ; 6- What framing at the international level? ; 7- Friction between climate and disaster risk reduction framing ; 8- Conclusion

Pringgokusuman Village is geographically located on the bank of the Winongo River which originates from the Merapi Volcano, so it has the potential risk of lahar floods and landslides. On the other hand, this village has a high density level which is dominated by 87 percent settlements area. The purpose of the study was to compile a participatory disaster map for flood and landslide disaster mitigation in Pringgokusuman Village, Yogyakarta City as an effort to support disaster mitigation learning and education for the community. The participatory mapping was carried out with indepth interview and Focus Group Discussion (FGD) activities focusing on flood and landslide. The results of the participatory disaster mapping include basic disaster information, the number of disaster events, the potential and risks of disasters that occur. The analysis of the results was analyzed qualitatively and then added with spatial information (spatial) with areas regarding disasters and potential disasters. The results of the FGD showed that the most common disasters were overflowing floods from the Winongo river and landslide along. This research can be used to supplement Geography lessons on the disaster theme. Kelurahan Pringgokusuman secara geografis berada di bantaran penggal Sungai Winongo yang berhulu dari Gunung Merapi, sehingga memiliki potensi risiko bencana banjir lahar dan tanah longsor. Disisi lain kelurahan ini memiliki tingkat kepadatan yang tinggi yang didominasi permukiman 87 persen. Tujuan penelitian ini adalah menyusun peta bencana secara partisipatif untuk mitigasi kebencanaan banjir dan longsor di Kelurahan Pringgokusuman Kota Yogyakarta sebagai upaya mendukung pembelajaran dan pendidikan mitigasi bencana untuk masyarakat. Pemetaan partisipatif dilakukan dengan wawancara mendalam dan kegiatan Fokus Grup Diskusi (FGD) berfokus pada bencana banjir dan longsor. Hasil dari pemetaan partisipatif kebencaan tersebut antara lain informasi dasar kebencanaan, jumlah kejadian bencana, potensi dan risiko bencana yang terjadi. Analisis hasil dilakukan secara deskriptif kualitatif kemudian ditambahkan informasi keruangan (spasial) dengan informasi area. Hasil FGD menunjukkan bencana yang sering terjadi adalah banjir luapan dai sungai Winongo dan longsor di sepanjang Winongo dan saluran selokan. Penelitian ini dapat menjadi suplemen dalam pembelajaran Geografi terkait tema bencana.

Objective To address the fact that Black adults (BAs) experience significantly greater stroke burden than the general population, we conducted a systematic literature review which described evidence-based interventions targeting secondary stroke risk reduction in BAs. Data Source Publications were selected from PubMed, Ovid, Cochrane, and Web of Science databases. We included peer-reviewed, longitudinal, English-language studies performed in the USA which reported results for BAs separately and had adult participants who had experienced stroke-related events. Results Six of the 7 studies employed behavioral interventions which promoted education on stroke risk factors, problem-solving skills, and healthy-coping strategies. These studies demonstrated improvements in one or more biologic outcomes including cholesterol control and systolic blood pressure. Conclusions Existing interventions on secondary stroke risk reduction approaches are effective in reducing secondary stroke risk among BAs, especially in individuals with poorly controlled blood pressure at baseline. However, additional research is needed because the current approaches may limit generalizability.

Le 2 octobre 2020, des précipitations diluviennes s'abattent sur l'arrière-pays niçois. Plusieurs vallées sont alors meurtries, dont la vallée de la Vésubie où le bilan humain et socio-économique a été lourd de conséquences. Un retour d'expérience (RETEX) sur les conséquences de la crue torrentielle a été réalisé quelques mois après la catastrophe. Celui-ci a concerné l'évaluation des impacts géomorphologiques de la crue torrentielle et des phénomènes gravitaires, l'évaluation de l'exposition des réseaux stratégiques aux inondations et aux mouvements de terrain. Le RETEX a permis une analyse critique des documents de prévention et de gestion en place au moment de la crue. Il souligne les vulnérabilités de ce territoire de montagne, certaines intrinsèques comme la diversité des aléas naturels et leur intensité, l'enclavement des vallées, l'espace restreint, etc., et d'autres externes comme l'implantation de populations et d'activités en zone à risque et le développement de réseaux stratégiques ou critiques non adaptés au contexte de la montagne. On october 2, 2020, heavy rain fell on the hinterland of Nice. Several valleys were affected, including the Vésubie valley, where severe human and socio-economic damages were reported. A feedback report (RETEX) on the effects of the torrential flood was carried out a few months after the disaster. This concerned the assessment of the geomorphological impacts of the torrential flood and gravity phenomena, the exposure of strategic networks to flooding and ground movements. The feedback report allowed a critical analysis of the prevention and management tools in place at the time of the flood. It underlines the vulnerabilities of this mountain territory, some intrinsic such as the diversity of natural hazards and their intensity, the enclosure of the valleys, the confined space... and others external such as the establishment of populations and activities in risky areas, the implementation of strategic or critical networks which are insufficiently adapted to the mountain context.

Dans le contexte d'aggravation des aléas naturels et des risques associés induits par la croissance urbaine, les sociétés doivent davantage répondre à l'enjeu du développement d'outils de prévention. Comme le souligne la stratégie internationale de réduction des risques naturels, les méthodes participatives, basées sur le partage de l'information et la transmission de connaissances sur les risques, sont plébiscitées. Nous présentons ici une démarche d'acquisition de savoirs sur les dynamiques naturelles et humaines dans un territoire à risque, à des fins de transmission d'une culture pratique du risque. Cette démarche, développée dans le cadre d'une recherche-action et généralisée dans un modèle, a été appliquée à trois territoires à risque glissement de terrain. À partir des similitudes et des contrastes dans la perception du risque par les populations et les acteurs, des pistes d'amélioration de la prévention sont proposées, en même temps que la posture de recherche-action pour traiter les risques majeurs est discutée. In the context of the worsening of the major natural hazards induced by urban growth, societies must respond more to the challenge of developing prevention tools. As underlined by the International Strategy for Disaster Reduction, participatory methods, based on the sharing of information and the transmission of knowledge on risks are acclaimed. We present here an approach to acquiring knowledge on natural and human dynamics in a territory subject to landslide risk for the purpose of transmitting a practical risk culture. This approach, developed through action research, generalized in a model, was applied to three landslide risk areas. Based on the similarities and contrasts in the perception of risk by the populations, ideas for improving prevention are proposed at the same time as the action-research posture to treat major risks is discussed.

Riveraine du Léman, la ville de Thonon-les-Bains, soucieuse de l'évolution morphologique de son littoral, a souhaité une collaboration entre chercheurs et praticiens sur la question de l'érosion des rives du lac. Un suivi sur 10 ans (2010-2020) a montré que le recul littoral, parfois important (jusqu'à 1,50 m), dépend à la fois de processus biophysiques (essentiellement les vagues et la dérive littorale créées par la bise) et de forçages anthropiques (rétention des sédiments par les barrages amont, activité de prélèvements de sédiments à l'embouchure de la Dranse dans le Léman et batillage initié par la navigation). L'impact majeur de cette érosion littorale exacerbée étant d'ordre économique (alimentation artificielle régulière coûteuse) et paysager (grignotage du sentier littoral risquant de déstabiliser le mur de Ripaille, patrimoine bâti de la ville), les propositions d'actions ont été fondées, d'une part, sur la restauration douce du littoral (génie végétal) et la suppression d'aménagements en dur (deux épis) pour faciliter la redistribution des sédiments par la dérive littorale et, d'autre part, sur un repositionnement quant à l'extraction des apports naturels de sédiments. Si un rapport de confiance a été établi entre les chercheurs et la ville, la décision de la préfecture de Haute-Savoie de ne pas reconduire l'autorisation de prélèvement sédimentaire, en se fondant, en partie, sur les conclusions de ces études, a suscité une vive réaction de l'entreprise, rendant le dialogue difficile. Toutefois la dernière étude menée sur le littoral thononais (suivi géomorphologique), en révélant une amélioration de la situation (entre 2014 et 2019, le pourcentage de littoral érodé est passé de 60 à 42 %), valorise la décision prise. Next to the Leman Lake, the city of Thonon-les-Bains monitors the morphological evolution of its shoreline. Therefore, the city has commissioned a series of studies over a 10 year-period. These studies have been carried out thanks to the cooperation of researchers in geography and experts in the private sector. The conclusion of the first study on erosion has shown that the significant decline of the shoreline (up to 1.5 meters) is due to biophysical (mainly waves and the lakeside drift caused by the north wind) and human forcing (retention of sediment by upriver dams, extraction of sediment at the intersection of the Dranse River and the Leman Lake and ship-generated waves). The main impact of this erosion is on the economy (frequent and expensive artificial supply of sand) and the landscape (damaged coastal path which endangers the stability of the Ripaille Wall, a built heritage of the city). Thus, proposals have been based on 1/ the soft restoration of the shoreline (eco-engineering techniques), 2/ the suppression of hard structures (two spurs to facilitate the distribution of sediments by the coastal drift), and 3/ a revision of the extraction of the natural supply of sediments. Confidence has been established between the city and the researchers. However, the decision made by the local government to stop future extractions of sediments has caused a strong reaction from the company. Subsequent dialogues have been difficult. Nevertheless, the latest study made on the lakeshore of Thonon has shown an improvement of the situation: the percentage of eroded lakeshore has decreased from 60 % to 42 % between 2014 and 2019. This result underlines the revelancy of the decision made by the local government, despite the fear of a possible socioeconomic fallout.

L'augmentation des températures dans un contexte de changement climatique devrait être accompagnée par une hausse de l'évaporation et de l'évapotranspiration (ET0). Toutefois des études ont montré une baisse de l'évaporation (ou de l'évapotranspiration) dans certaines régions du monde. Ce contraste entre la baisse de l'évaporation et l'augmentation des températures, qui varie en fonction des zones climatiques, est connu sous le nom de "paradoxe d'évaporation". L'objectif de ce travail est d'en examiner les causes dans la vallée du fleuve Sénégal. Les données climatiques (évaporation, pluie, température, humidité relative, durée d'insolation) observées aux stations de Bakel, Podor, Matam et Saint-Louis, ont été traitées sur la période 1981-2015. La méthodologie comporte : 1/ la détection des ruptures par le test de PETTITT, 2/ l'analyse de la relation entre l'évaporation / évapotranspiration et les variables climatiques par le test de corrélation de PEARSON, 3/ la détection des tendances de l'évaporation / ET0 et des variables climatiques par le test de MANN-KENDALL et la pente de SEN. Les ruptures de l'évaporation et de l'évapotranspiration sont respectivement identifiées dans les années 1990 et 2000. La corrélation de PEARSON montre que l'évaporation et l'ET0 ont pour relation la plus forte, celle avec l'humidité relative. Le test de MANN-KENDALL révèle une baisse significative (p-value ˂ 0,001) de l'évaporation et une évolution nuancée (baisse et hausse) de l'évapotranspiration de référence. Cette baisse de l'évaporation, combinée à une hausse significative de la température, met en évidence l'existence d'un paradoxe d'évaporation dans la vallée du fleuve Sénégal. Ce paradoxe d'évaporation s'explique ici par la hausse significative de l'humidité relative et de la pluviométrie, mais aussi par la baisse significative de la durée d'insolation. The increase in temperatures in a context of climate change should be accompanied by an increase in evaporation or evapotranspiration (ET0). However, studies have shown a decrease in evaporation (or evapotranspiration) in certain regions of the world. This contrast between the decrease in evaporation and the increase in temperature, which varies according to the climatic zones, is known as the "evaporation paradox". The objective of this work is to examine the causes in the climatic context of the Senegal River Valley. The climatic data (evaporation, rain, temperature, relative humidity, insolation) observed at the stations of Bakel, Podor, Matam and Saint-Louis were used over the period 1981-2015. The methodology includes: 1/ the detection of ruptures by the PETTITT test, 2/ the analysis of the relationship between evaporation / evapotranspiration and climatic variables by the PEARSON correlation test, 3/ the detection of trends in Evaporation / ET0 and climate variables by the MANN-KENDALL test and SEN’s slope. The breaks in evaporation and evapotranspiration are respectively identified in the 1990s and 2000s. The PEARSON correlation shows that evaporation and ET0 have their strongest relationship with the relative humidity. MANN-KENDALL's test reveals a significant decrease (p-value ˂ 0.001) in evaporation and a mixed trend (decrease and increase) in reference evapotranspiration. This decrease in evaporation, combined with a significant increase in temperature, highlights the existence of an evaporation paradox in the Senegal river valley. This evaporation paradox is explained here by the significant increase in relative humidity and rainfall, but also by the significant decrease in sunshine hours.

[Background and Aims] Multiple developments of squamous dysplasia and squamous cell carcinoma (SCC) in the upper aerodigestive tract have been explained by field cancerization phenomenon and were associated with alcohol and cigarette use. Second primary SCC development after curative treatment impairs patients’ quality of life and survival; however, how these consumption and cessation affect field cancerization is still unknown. [Methods] This is a multicenter cohort study including 331 patients with superficial esophageal SCC (ESCC) treated endoscopically and pooled data from 1022 healthy subjects for comparison. Physiological condition in the background esophageal mucosa was classified into 3 groups based on the number of Lugol-voiding lesions (LVLs) per endoscopic view: grade A, 0; grade B, 1–9; or grade C, ≥10 LVLs. Lifestyle surveys were conducted using a self-administered questionnaire. Patients were counseled on the need for alcohol and smoking cessation by physicians and were endoscopically surveyed every 6 months. [Results] LVL grades were positively associated with alcohol drinking intensity, flushing reactions, smoking, and high-temperature food and were negatively associated with eating green and yellow vegetables and fruit. Second primary ESCC and head/neck SCC were significantly more prevalent in the grade C LVL (cumulative 5-y incidences 47.1%, 95% confidence interval [CI] = 38.0–57.2 and 13.3%, 95% CI = 8.1–21.5, respectively). Alcohol and smoking cessation significantly reduced the development of second primary ESCC (adjusted hazard ratios 0.47, 95% = CI 0.26–0.85 and 0.49, 95% CI = 0.26–0.91, respectively). [Conclusion] Alcohol drinking, smoking, flushing reaction, and high-temperature food were closely associated with field cancerization, and cessation of alcohol and smoking significantly reduced the risk of development of second primary cancer. UMIN Clinical Trials Registry ID:UMIN000001676.

Observational population studies indicate that prevention of dementia and cognitive decline is being accomplished, possibly as an unintended result of better vascular prevention and healthier lifestyles. Population aging in the coming decades requires deliberate efforts to further decrease its prevalence and societal burden. Increasing evidence supports the efficacy of preventive interventions on persons with intact cognition and high dementia risk. We report recommendations for the deployment of second-generation memory clinics (Brain Health Services) whose mission is evidence-based and ethical dementia prevention in at-risk individuals. The cornerstone interventions consist of (i) assessment of genetic and potentially modifiable risk factors including brain pathology, and risk stratification, (ii) risk communication with ad-hoc protocols, (iii) risk reduction with multi-domain interventions, and (iv) cognitive enhancement with cognitive and physical training. A roadmap is proposed for concept validation and ensuing clinical deployment.

Research on women’s response and resistance to sexual assault risk has informed the development of interventions to improve women’s ability to effectively resist sexual assault. However, little is known about how women anticipate, navigate, and respond to risk following participation in sexual assault risk reduction/resistance education programs. In this study, we examined the information and skills used by university women who had recently completed the effective Enhanced Assess, Acknowledge, Act (EAAA) sexual assault resistance program. We analyzed responses from 445 women using descriptive statistics and content and thematic analysis. Just under half (42%) of women used at least one EAAA strategy in the following 2 years. Most women reported that their efforts were successful in stopping an attack. Women’s responses included strategies both to preempt sexual assault threat (e.g., avoiding men who display danger cues, communicating assertively about wanted and unwanted sex) and to interrupt or avoid an imminent threat (e.g., yelling, hitting, and kicking). Women’s use of resistance strategies worked to subvert gendered social norms and socialization. The results suggest that counter to criticisms that risk reduction/resistance programs blame women or make them responsible for stopping men’s violence, women who took EAAA typically positioned themselves as agentic and empowered in their resistance.

The SHAHRP program was effective reducing drinking and alcohol - harms in Australia, but cross-cultural adaptation is required before replication. This study aimed at assessing the feasibility of SHAHRP in Brazil focused on implementation and acceptability. A mixed-methodsdesign was used: quantitative for implementing the program and evaluation and qualitative for acceptability. The quantitative design was a pilot of a randomized controlled trial. Private schools were randomly divided into four intervention (n=160) and four control (n=188) schools. Student’s mean age was 12.7 years. The fidelity of implementation and likely outcome measures were assessed. Qualitative data on acceptability were provided by students and teachers. The percentage of implementation varied from 62.5% to 87.5%. Behaviours such as alcohol-harms requires a larger cohort and longer follow-up to be adequately evaluated. The risk reduction approach and activities had good acceptability from students and teachers. Quantitative and qualitative outcomes on knowledge and decision-making indicated possible improvement in SHAHRP schools. The program is feasible and well accepted in a Brazilian setting, opening the way for a more comprehensive evaluation and dissemination. Resumo O programa SHAHRP foi eficaz na Austrália, mas precisa de adaptação transcultural para replicação em outro país. Este estudo teve como objetivo avaliar a viabilidade do SHAHRP no Brasil com base na sua implementação e aceitação. Utilizou-se métodos mistos: quantitativo para a implementação do programa e da avaliação e qualitativo para aceitação. O desenho quantitativo foi o piloto de um estudo clínico randomizado. Participaram escolas particulares: quatro intervenções (n = 160) e quatro controles (n = 188). Os alunos tinham 12,7 anos em média. A fidelidade da implementação e possíveis medidas de resultados foram avaliadas. Os dados qualitativos sobre aceitação foram relatados por alunos e professores. A fidelidade de implementação variou de 62,5% a 87,5%. Comportamentos como danos causados pelo uso de álcool precisam de uma amostra maior e de mais tempo para avaliação. A abordagem de redução de riscos e as atividades do programa foram bem aceitas por alunos e professores. Os resultados quantitativos e qualitativos sobre conhecimento e tomada de decisão indicaram possível melhora nas escolas-intervenção. O programa é viável e bem aceito no cenário brasileiro, abrindo caminho para avaliação e disseminação mais abrangentes.

This research explored Dhaka slum dwellers’ (n=434 using convenience, quota, and judgmental sampling) view about COVID-19, its causes, preventive measures, potential high-risk groups, self-awareness, transmission prevention, orthodox beliefs, and vaccine effectiveness using 56 simple variables grouped in eight complex variables. The slum dwellers viewed COVID-19 as a fatal and chronic disease spread by Chinese. They perceive that direct contact with infected persons, cough and sneeze droplets, and physical proximity cause the disease. Regarding preventive measures, they think that they must wear masks, frequently wash hands, face, and feet, use soap or hand sanitizer to wash hands. They assume that hot water gargle, more lime/lemon intake, sunlight exposure, and physical activities can reduce the risk of infection. They also perceive that people of any age bear the risk of contagion; but asthmatic, heart and diabetic patients fall in the high-risk group. The slum people self-protect covering nose and mouth while sneeze and cough, take precaution if tested positive, and maintain social distance. They take this disease seriously, as such, they wear masks, avoid guests, friends, and mass transports. They subscribed that if affected they will be in self-quarantine and follow prescribed movement and lockdown decisions to prevent transmission. They believe that home quarantine is for the infected persons only. Slum residents are found to recognize preventive mechanism and self-awareness tactics; but they are carried away by some religious beliefs like the disease is Allah’s will, a curse from Allah, results of our misdeeds, and Allah will save COVID-affected people. Because of their doubt of vaccine effectiveness, they are not quite confident about taking vaccine. Overall, the respondents do not think that they are risk-free. It is found that some of their views are not factual, like COVID-19 is a chronic disease, spread by Chinese; sunrays, hot water gargle reduces risks; lime/lemon intake prevent the disease; or diabetic, asthmatic, and heart patients are at more risks. It is noted that most of the perceptional differences are observed with family types. Nuclear family respondents believe that cold weather causes it and perceive strongly that asthmatic patients are more susceptible to infection. They perceive similar risk of being affected if exposed to a diseased person; however, infected elderly people with comorbidities are more prone to serious illness. They blindly perceive that COVID-19 is all Allah’s will. Education wise, the participants differ in their opinion in almost all the variables. Female slum members firmly believe that Chinese has brought the disease; but males are noted to be more self-aware than females. Married slum residents strongly believe that sunlight exposure and physical activities can prevent the disease and hold the misconception that COVID-19 is a curse from Allah and results of all our misdeeds. Irrespective of their literacy level all respondents believe that Allah will save COVID-affected people. Further, occupation-wise slum dwellers have similar viewpoint about preventing the disease and curbing community transmission. Slum residents’ opinion related to causes of the disease and vaccination has no association with age and income. Older slum residents are found to be more self-aware and cautious in limiting disease transmission, although they possess stronger orthodox religious views and more dubious about vaccination. Slum dwellers’ perception to several aspects of COVID-19 are noticed to be weakly positively related with income, indicating that even when the relatively higher income groups retain views closer to reality, their tendency to be conscious and abide by protective mechanism to reduce risk and control spread of the disease is less as opposed to insolvent slum inhabitants. The factor analysis has found that the grouping variables and the factor variables are quite consistent. It is noted that “self-awareness” and “risk reduction” are the most important factors followed by perception regarding COVID-19 vaccine. In short, slum dwellers are not observed to have a very clear idea about COVID-19, its causes, prevention mechanism, etc. They are aware of some methods of self-protection and deterrence of transmission. However, it is to be ensured that they strictly follow the methods to protect themselves and avoid community spread of the disease.

The United States and Russia agreed to extend the 2010 New START Treaty in February 2021. Many analysts believed that this step would reinvigorate the US-Russian arms control process, lead to deeper reductions in nuclear weapons, and possibly pave the path to nuclear disarmament. However, the United States and Russia might find it difficult to agree on an agenda for the next round of arms control negotiations, and neither may be willing to accept deeper reductions in their numbers of nuclear weapons. Changes in the international security environment, stresses in the US-Russian relationship, and increases in the size and scope of China’s nuclear arsenal may all impede progress. As a result, the next steps in arms control may focus on transparency, communication, norms, and risk reduction measures, both as a way to mitigate the risk of nuclear war and to, possibly, create the conditions needed for further reductions in the future.

Supportind data for paper.

This online study will examine the following objectives: 1) The association between cumulative chronic stress across the lifespan and cognitive function in domains of executive function, memory, and global cognition among older adults aged 60+ 2) The relative associations between period of chronic stress exposure (early, middle, and late life) and cognitive function in all domains among older adults aged 60+ 3) The moderating role of a healthy lifestyle (Mediterranean diet pattern, physical activity, social engagement, sleep, mindful relaxation) in the aforementioned relationship among older adults aged 60+

A brief idea

The increasing availability of open-source and high-quality satellite data has facilitated market developments in the index insurance sector. So far, research and industry spheres have used administrative boundaries of units to estimate regional index values for insurance design. In areas with heterogeneous land use or land cover, however, these indices do not provide sufficient accuracy. This study analyzes potential accuracy gains from land-use classification that allow to design indices specifically for croplands and wheatlands. The validity of this approach is tested along conventional satellite-based products, including the Normalized Difference Vegetation Index (NDVI) and Land Surface Temperature (LST), as well as indices that are not yet widely used in crop insurance industry, like the Enhanced Vegetation Index (EVI), Green Chlorophyll Index (GCI) and Leaf Area Index (LAI). The study covers 2060 yield observations from 152 districts across Central Asia and Mongolia with irrigated, mixed and rainfed wheat farming systems. The results show that the majority of these indices are suitable for detecting wheat yield variations in rainfed and mixed agricultural lands, although they remain ambiguous in irrigated lands. Land-use classification and designing indices based on croplands and wheatlands noticeably increases the relationship between indices and wheat yields in rainfed and mixed lands. Notably, the LAI and GCI out-perform other well-known indices. Overall, freely available satellite data could serve as a good source for establishing index insurance products in Central Asia and Mongolia. Nevertheless, a careful assessment and selection of index and land use classification remains essential.

Many recent examples have shown that rockfalls can occur in underground steep coal mines. The stratigraphic circumstances, block formation mechanism, and cumulative damage effects of rockfalls in the longwalls of a steeply dipping coal seam (SDCS) make them detrimental to workplace safety. Therefore, this study examined an approach for mitigating rockfall hazards in SDCSs. A passive mesh system was installed to prevent the propagation of rockfalls, which decreased the number of collisions between the falling rocks and mining equipment. The interactions of the falling rocks and passive mesh were studied using a series of full-scale numerical impact tests. The following conclusions could be drawn. The displacement of the mesh increased with the rockfall kinetic energy, showing the characteristic of strain hardening. The peak stress appeared near the contact area between the rockfall and mesh, and it spread to the mesh edge in an X-shaped pattern. Stress concentrations were likely to occur in areas that were in direct contact with the mesh and mesh edges. The displacement of the mesh increased when the incidence angle increased, and the number of mesh cells entering the plastic state increased significantly. The internal energy ratio increased with an increase in the incidence angle, indicating that a greater incidence angle led to a larger amount of kinetic energy being transferred from the block into the internal energy of the passive mesh. Finally, the method was verified by comparing the numerical test with the on-site damaged equipment. The high replacement frequency of a passive mesh system and the annual fatality rate in the longwalls of SDCS were significantly improved. This study provided the design for a drapery mesh system for rockfall disaster prevention, particularly the mitigation of rockfall hazard risks in underground SDCSs.

Purpose To estimate the effectiveness of tailored physical activity and dietary interventions amongst adults attending colorectal and breast cancer screening. Methods Five literature databases were systematically searched to identify randomised controlled trials (RCTs) of tailored physical activity and/or dietary interventions with follow-up support initiated through colorectal and breast cancer screening programmes. Outcomes included markers of body fatness, physical activity, and dietary intake. Mean differences (MDs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random effects models. Results Five RCTs met the inclusion criteria encompassing a total of 722 participants. Diet and physical activity interventions led to statistically significant reductions in body mass (MD − 1.6 kg, 95% CI − 2.7 to − 0.39 kg; I2 = 81%; low quality evidence), body mass index (MD − 0.78 kg/m2, 95% CI − 1.1 to − 0.50 kg/m2; I2 = 21%; moderate quality evidence), and waist circumference (MD − 2.9 cm, 95% CI − 3.8 to − 1.91; I2 = 0%; moderate quality evidence), accompanied by an increase in physical activity (SMD 0.31, 95% CI 0.13 to 0.50; I2 = 0%; low quality evidence) and fruit and vegetable intake (SMD 0.33, 95% CI 0.01 to 0.64; I2 = 51%; low quality evidence). Conclusion There is low quality evidence that lifestyle interventions involving follow-up support lead to modest weight loss and increased physical activity and fruit and vegetable intake. Due to the modest intervention effects, low quality of evidence and small number of studies, further rigorously designed RCTs with long-term follow-up of modifiable risk factors and embedded cost–benefit analyses are warranted (PROSPERO ref: CRD42020179960).

Objective: To study compliance and effectiveness of the mHealth nutrition and lifestyle coaching program Smarter Pregnancy in couples undergoing in vitro fertilization (IVF) treatment with or without intracytoplasmic sperm injection (ICSI).Design: Multicenter, single-blinded, randomized controlled trial, conducted from July 2014 to March 2017.Setting: IVF clinics.Patient(s): A total of 626 women undergoing IVF treatment with or without ICSI and 222 male partners.Interventions(s): Couples were randomly assigned to the light (control group) or regular (intervention group) Smarter Pregnancy program. Both groups filled out a baseline screening questionnaire on nutrition and lifestyle behaviors, and the intervention group received coaching tailored to inadequate behaviors during the 24-week period.Main Outcome Measure(s): Difference in improvement of a composite dietary and lifestyle risk score for the intake of vegetables, fruits, folic acid supplements, smoking, and alcohol use after 24 weeks of the program.Result(s): Compared with control subjects, women and men in the intervention group showed a significantly larger improvement of inadequate nutrition behaviors after 24 weeks of coaching. At the same time, the women also showed a significantly larger improvement of inadequate lifestyle behaviors.Conclusion(s): The mHealth coaching program Smarter Pregnancy is effective and improves the most important nutritional and lifestyle behaviors among couples undergoing IVF/ICSI treatment. International multicenter randomized trials are recommended to study the effect of using Smarter Pregnancy on pregnancy, live birth, and neonatal outcome. ((C)2020 by American Society for Reproductive Medicine.)yy

The occurrence of landslides in mountainous areas of Nepal is recurrent phenomena and this can be disastrous if occurred within human settlements. Proper research is required to manage and reduce the risks of the disaster in places where landslides had occurred frequently. In risk assessment estimation of vulnerability is one major component. This research was aimed to generate information on the vulnerability of people in the Panchase area of central Nepal. The method of analytical hierarchy process was used to define the weightage to be assigned for 4 factors and 26 indicators used in the research. 377 households were surveyed with a questionnaire designed to collect information on those indicators. The households sampled for the survey were made sure that they were near or around the landslide affected area. The response for each indicator was converted into scores which when summed up yielded the vulnerability score. This score for each household was used to categorize households into five levels of vulnerability from very low, low, moderate, high, to very high. The numbers of households in each category were 16, 92, 191, 75, and 3 respectively. Environmental and economic indicators were inflicting higher vulnerability in this research location. Remoteness and lesser number of facilities and/or services, lower numbers of governmental offices, absence of banking and financial institutions, lesser preferences for insurances and savings, degraded natural water sources were major determinants of higher vulnerability in Panchase. These indicators should be prioritized during disaster risk management in Panchase.

In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographical location, representativeness, diversity, duration, mechanisms, and research on combinations of risk factors were identified. Future research to inform dementia risk reduction should fill gaps in the evidence base, take a life-course, multi-domain approach, and inform population health approaches that improve the brain-health of whole communities.

This article constructs and demonstrates an alternate probabilistic approach (using incidence rate restricted model), compared with the deterministic mathematical models such as SIR, to capture the impact of healthcare efforts on the prevalence rate of the COVID-19’s infectivity, hospitalization, recovery, and mortality in the eastern, central, mountain, and pacific time zone states in the USA. We add additional new properties for the incidence rate restricted Poisson probability distribution. With new properties, our method becomes feasible to comprehend not only the patterns of the prevalence rate of the COVID-19’s infectivity, hospitalization, recovery, and mortality but also to quantitatively assess the effectiveness of social distancing, healthcare management’s efforts to hospitalize the patients, the patient’s immunity to recover, and lastly the unfortunate mortality itself. To make regional comparisons (as the people’s movement is far more frequent within than outside the regional zone on daily basis), we group the COVID-19 data in terms of eastern, central, mountain, and pacific zone states. Several non-intuitive findings in the data results are noticed. They include the existence of imbalance, different vulnerability, and risk reduction in these four regions. For example, the impact of healthcare efforts is high in the recovery category in the pacific states. The impact is less in the hospitalization category in the mountain states. The least impact is seen in the infectivity category in the eastern zone states. A few thoughts on future research work are cited. It requires collecting rich data on COVID-19 and extracting valuable information for better public health policies.

Numerous slope failures have been noticed in the Panchase region of central Nepal posing threats to people and biodiversity. Considering the need to reduce landslide risks, this research determined the spatial extent of landslide hazard degrees in the Panchase area. The research site, with an area of 278.324 km2, consists of parts of the Kaski, Parbat, and Syangja Districts. A Statistical Index Method was used for hazard analysis that produced weights. Positive weight values for each factor class represented a higher hazard and vice versa. An inventory of the study area identified 556 landslides measuring 1.511 km2 indicating a landslide density of 2 per km2 area. Thirteen percent (36.18 km2) of the total experimental area was rated as a very high hazard zone. Similarly, the area occupied by high hazard and moderate hazard zones were 77.66 km2 (28%), and 81.83 km2 (29%) respectively. The validation showed that the method can produce results with of accuracy of 82.8%. This indicated the hazard assessment process is acceptable and replicable. The factor classes having greater influence for higher landslide hazard are: near the streams, near the roads, barren or grassland, land with phyllite bedrocks, land receiving rainfalls greater than 4,000 mm, lands with an elevation range from 1,000 m to 1,500 m, slopes steeper than 30°, and south-facing slope. During risk management work by local authorities, considerations should be given to these factors and areas with higher hazards.

Statins, which are competitive inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, reduce cholesterol blood levels and the risk of developing cardiovascular diseases and their related complications. In addition to this main activity, statins show pleiotropic effects such as antioxidant, anti-inflammatory and antiproliferative properties, with applications in many pathologies. Based on their antiproliferative properties, in vitro and in vivo studies have investigated their effects on various types of cancer (i.e., breast cancer, prostate cancer, colorectal cancer, ovarian cancer, lung cancer) with different genetic and molecular characteristics. Many positive results were obtained, but they were highly dependent on the physiochemical properties of the statins, their dose and treatment period. Combined therapies of statins and cytotoxic drugs have also been tested, and synergistic or additive effects were observed. Moreover, observational studies performed on patients who used statins for different pathologies, revealed that statins reduced the risk of developing various cancers, and improved the outcomes for cancer patients. Currently, there are many ongoing clinical trials aimed at exploring the potential of statins to lower the mortality and the disease-recurrence risk. All these results are the foundation of new treatment directions in cancer therapy.

Introduction. Rural Americans (RA) have poorer vascular health and physical activity levels than their urban counterparts; all are dementia risk factors. Dementia risk reduction among rural individuals requires a tailored approach. The purpose of this project was to examine preliminary efficacy of a community-based physical exercise and/or dementia risk factor-reduction curriculum among rural adults 50 and older. Methods. Seventy-five rural dwelling adults 50 and older were randomized to one of three groups: 1) 10 weeks of Alzheimer’s disease risk-reduction education (ED), 2) risk-reduction education and supervised exercise (EDEX) or 3) control group (CON). Outcomes included baseline to 10-week follow-up difference in dementia knowledge (primary outcome) and physical activity, muscular endurance, healthy lifestyle engagement, and anthropometrics (secondary outcomes). Results. Sixty-nine adults successfully completed the 10-week study. Dementia knowledge increased in a Treatment Arm-dependent manner (χ2 = 6.95 (2), p = 0.03), being ED and EDEX superior to CON. Engagement in healthy lifestyle behaviors did not change statistically. However, participation specifically in physical activity increased over time (χ2 = 11.47 (2), p = 0.003) with EDEX reporting the greatest increases. No significant change in average daily steps was observed for any group. Conclusion. The results suggested dementia risk-reduction education, both with and without structured exercise, leads to improvements in dementia knowledge. When coupled with regular, supervised exercise, this education intervention also helped participants increase engagement in physical activity over 10 weeks. Tailored interventions that combine Alzheimer’s disease education and regular, supervised exercise may help reduce dementia risk in rural communities.

This paper examines the return links and volatility transmission between Chinese stock and commodity futures markets and draws implications for portfolio risk management. To these ends, we consider three vector autoregression-multivariate generalized autoregressive conditional heteroskedasticity-class models with which to model volatilities and conditional correlations between Chinese stock and three commodity futures markets. Our empirical results reveal evidence of return linkage and volatility transmission between the Chinese stock and commodity futures markets. We also analyse optimal portfolio weights and hedging ratios between s1tock–commodity pairs. Finally, we assess implications for mixed commodity–stock portfolios and find strong evidence of hedging effectiveness and downside risk reductions. Refereed/Peer-reviewed

The affordability of property-level adaptation measures against flooding is crucial due to the movement toward integrated flood risk management, which requires the individuals threatened by flooding to actively manage flooding. It is surprising to find that affordability is not often discussed, given the important roles that affordability and social justice play regarding flood risk management. This article provides a starting point for investigating the potential rate of unaffordability of flood risk property-level adaptation measures across Europe using two definitions of affordability, which are combined with two different affordability thresholds from within flood risk research. It uses concepts of investment and payment affordability, with affordability thresholds based on residual income and expenditure definitions of unaffordability. These concepts, in turn, are linked with social justice through fairness concerns, in that, all should have equal capability to act, of which affordability is one avenue. In doing so, it was found that, for a large proportion of Europe, property owners generally cannot afford to make one-time payment of the cost of protective measures. These can be made affordable with installment payment mechanisms or similar mechanisms that spread costs over time. Therefore, the movement toward greater obligations for flood-prone residents to actively adapt to flooding should be accompanied by socially accessible financing mechanisms.

Background and aim: Pulmonary thromboembolism is one of the most common causes of non-surgical death in patients following urological abdominopelvic surgery. Since the beginning of prophylaxis for venous thromboembolic disease, episodes of deep vein thrombosis and pulmonary thromboembolism have decreased. Our objective is to analyse the prognosis factors of thromboembolic disease, the clinical variability in the use of pharmacological prophylaxis and the results of its application. Material and methods: Retrospective multicentric study of 610 patients undergoing radical prostatectomy between December 2013 and November 2014, in 7 general hospitals in Spain, Italy and Portugal. Patients were classified according to their baseline characteristics into thrombotic risk groups and haemorrhagic risk groups. The venous thromboembolic events that occurred in the different groups were analysed. Results: The average age was 65.22 years (48-78). The average body mass index was 26.7 and the average ASA risk 2.1. In all patients, early mobilization began in the first 24 hours. In 4.1% intermittent pneumatic compression was used and 84.6% received pharmacological prophylaxis with low molecular weight heparins. Only 3.4% used the combination of mechanical prophylaxis with pharmacological prophylaxis. We observed a decrease in the incidence of thromboembolic events in the patients who received pharmacological prophylaxis, with an absolute risk reduction of 6.8%. There was no increase in the risk of haemorrhage in the patients who received pharmacological prophylaxis. Conclusions: In this study on patients undergoing radical prostatectomy, there was no difference in haemorrhagic complications derived from the use of pharmacological prophylaxis for venous thromboembolic disease. Pharmacological prophylaxis reduces the risk of presenting a thromboembolic event in patients undergoing radical prostatectomy, although this risk is not associated with the approach technique. © 2019 Elsevier España, S.L.U.

Cadmium has long been recognized as an environmental contaminant that poses risks to human health. Cadmium is of concern since nearly everyone in the general population is exposed to the metal through the food supply and the ability of the element to accumulate in the body over a lifetime. In support of the United States Food and Drug Administration's (FDA) Toxic Element Working Group's efforts to reduce the risks associated with elements in food, this review sought to identify current or new mitigation efforts that have the potential to reduce exposures of cadmium throughout the food supply chain. Cadmium contamination of foods can occur at various stages, including agronomic production, processing, and consumer preparation for consumption. The presence of cadmium in food is variable and dependent on the geographical location, the bioavailability of cadmium from the soil, crop genetics, agronomic practices used, and postharvest operations. Although there are multiple points in the food supply system for foods to be contaminated and mitigations to be applied, a key step to reducing cadmium in the diet is to reduce or prevent initial uptake by plants consumed as food or feed crops. Due to complex interactions of soil chemistry, plant genetics, and agronomic practices, additional research is needed. Support for field‐based experimentation and testing is needed to inform risk modeling and to develop practical farm‐specific management strategies. This study can also assist the FDA in determining where to focus resources so that research and regulatory efforts can have the greatest impact on reducing cadmium exposures from the food supply. Practical Application The presence of cadmium in food is highly variable and highly dependent on the geographical location, the bioavailability of cadmium from the soil, crop genetics, and agronomic practices used. This study can assist the FDA in determining where to focus resources so that research and regulatory efforts can have the greatest impact on reducing cadmium exposures from the food supply.

According to FEMA and NOAA, flooding is the most frequent and costly natural disaster in the United States. The National Flood Insurance Program, designed to alleviate some of the costs of this hazard, is financially insolvent and fiscally unsustainable. Through its Hazard Mitigation Assistance program, FEMA buys out homes, but the process is voluntary and slow, and demand far exceeds funds available. Consequently, the number of Repetitive Loss and Severe Repetitive Loss properties increases each year. The thesis explores why and how FEMA should pursue strategic retreat from high-risk areas. Disaster costs continue to rise as extreme weather events increase in frequency and intensity. Sea-level rise endangers coastal regions, and more homes may be susceptible to systemic and regular flooding than official estimates show. To resist by building ever larger flood walls and barriers may be unrealistic, and retreat as an adaptation technique may be preferable. Expensive as strategic retreat may be, loss-avoidance studies indicate that besides reducing pain and suffering, these measures pay for themselves. Strategic retreat may also result in climate refugees who are not prepared to deal with rapidly changing conditions. An adaptation framework recommends deterrents and incentives available to policymakers and practitioners to pursue strategic retreat in a planned, comprehensive, and equitable manner. Civilian, Department of Homeland Security Approved for public release. Distribution is unlimited.

Public earthquake early warning (PEEW) systems are intended to reduce individual risk by warning people ahead of shaking and allowing them to take protective action. Yet very few studies have assessed their actual efficacy from a risk-reduction perspective. Moreover, according to these studies, a majority of people do not undertake safety actions when receiving the warning. The spectrum of PEEW systems has expanded, with a greater diversity of actors (from citizens to private companies), increased independence from national authorities, and greater internationality. Beyond differences in warning and messaging strategies, systems’ characteristics may impact the way the public perceive, trust, understand, and respond to these warnings, which in turn will influence PEEW systems’ efficacy and perceived usefulness, enhancing the need for additional research. We take the example of earthquake network, an independent, voluntary, community- based and free system that offers a PEEW service. Through a quantitative survey (n = 2625), we studied users’ perception and reaction to a warning sent related to an M 8.0 earthquake in Peru (where no national system existed). We observed that even though only a minority of users actually took protective action, the system was appreciated and perceived as useful by the majority because it enabled mental preparation before the shaking. We found evidence for a tolerance for perceived late, missed, and false alerts. However, because it is a voluntary and independent system, the social dimension of the warning was incomplete because only a fringe of the population benefited from the warning. Therefore, many users’ first reaction was to warn their relatives. We discuss the need for partnerships between PEEW operators and national authorities to guarantee universal access to the service and maximize PEEW system efficacy.

Aim Research has shown that families’ participation in a cardiovascular disease (CVD) prevention programme could boost early adoption of healthy lifestyle behaviours in families. Behaviour-based, eHealth interventions are a potential means of achieving this. This study aimed to explore expectations of families—parents and children—at risk of CVD towards the design and functionality of an eHealth family-based CVD-risk reduction programme ‘Health-e-Hearts’. Methods and results Three online focus groups were conducted with six families comprising at least one parent at risk of CVD and at least one child aged 5–17 years. The focus groups were video and audio recorded and transcribed. Content analysis was used to synthesize and identify key categories and subcategories regarding development of and engagement with an eHealth programme. Three categories emerged: experiences of health apps and devices; eHealth application needs of family members; and motivators for using an eHealth programme. Experiences included using health apps individually and inconsistently. Needs included personalization, free and easy-to-use, time efficient, and multiple content formats. Motivators for engaging with the programme included goal setting, rewards, and competition. Conclusion Families’ expectations of an eHealth family-based CVD-risk reduction programme include the incorporation of personalized, easy-to-use design features and motivators for engaging with the programme. Family involvement in the development of an eHealth programme such as ‘Health-e-Hearts’ has the potential to boost early adoption of healthy lifestyle behaviours among all family members.

Extreme Heat Events (EHE) are a major concern for many urban areas worldwide and are considered as one of the deadliest natural hazards globally. Climate change and socioeconomic trends (exposure and susceptibility) are expected to exacerbate the risk of urban heat stress. Several urban areas have recently declared a climate emergency and initiated the adaptation process, but progress is still patchy, uncoordinated, and of varied quality. The main constraint is the lack of mechanisms for monitoring and reporting adaptation strategies, not allowing the supervision and evaluation of the adaptation process. The EU-funded project U-ADAPT! (Urban-Adaptation) focuses on the concrete expression of adaptation to evaluate the current implementation and effectiveness of adaptation measures and strategies to reduce Heat Disaster Risk (HDR), moving the emphasis from the study of vulnerability, resilience, and potential adaptation (adaptation capacity) of communities to the actual depth and pace of the past and current adaptation process. In this article, we discuss the theoretical support and design of the project and set the base for next project stages, which ultimately aims to create a unique interdisciplinary framework and a replicable multidimensional indicator on adaptation to EHE that empower European Union citizens to demand a safe and sustainable environment and hold institutions accountable for the adaptation process to current and upcoming risks., Departamento de Geografía, Historia y Filosofía, Universidad Pablo de Olavide

Ponencia presentada en: XII Congreso de la Asociación Española de Climatología celebrado en Santiago de Compostela entre el 19 y el 21 de octubre de 2022. [ES]Los Eventos de Calor Extremo (ECE) son una gran amenaza para muchas ciudades y están consideradas como uno de los peligros más mortales a nivel mundial. En este trabajo se describe el marco de trabajo desarrollado por el proyecto U-ADAPT! (Urban-Adaptation), financiado por la Unión Europea. El marco de trabajo proporciona una completa herramienta analítica para entender, explicar y desarrollar adaptaciones a las condiciones de calor extremas en zonas urbanas. Fue construido a partir de un proceso iterativo con base en literatura científica, planes de adaptación de ciudades y en participación pública de actores relevantes como un primer paso para generar un indicador que mida el grado de adaptación de las ciudades europeas. UADAPT! se estructura en cinco metas generales en relación con cinco dominios diferentes: (i) el efecto isla de calor, (ii) la exposición a ECE, (iii) la sensibilidad a ECE, (iv) la capacidad de reacción, (v) la capacidad de adaptación. Estas cinco metas se despliegan en veintidós objetivos de adaptación que son a su vez desarrollados en un total de ciento veinticinco medidas y estrategias de adaptación específicas. De esta manera, U-ADAPT! pretende centrarse en la evaluación de la profundidad y velocidad del proceso de adaptación y crear una herramienta que permita a los ciudadanos demandar un entorno seguro y sostenible a las instituciones responsables del proceso de adaptación. [EN]Extreme Heat Events (EHE) are a major concern for many urban areas worldwide and are considered as one of the deadliest natural hazards globally. In this work, we describe the U-ADAPT! framework for urban adaptation to extreme heat. The framework of this EU-funded project for urban adaptation to Extreme Heat Events presented in this paper provides a heuristic analytical tool for understanding, explaining, and developing local adaptation to extreme heat conditions. It was developed in an iterative process building on existing scholarly debates, on administrative adaptation plans, and on participatory consultation with community stakeholders as a prior step to develop an indicator to ground-test adaptation in European Union’s urban areas. The framework is structured across five different adaptation goals in relation with five different domains: (i) urban heat island effect, (ii) EHE exposure, (iii) EHE sensitivity, (iv) EHE coping capacity, (v) EHE adaptive capacity. These goals are in turn unfolded into twenty-two adaptation objectives, each of one extensively described and illustrated through a collection of specific adaptation measures or strategies. U-ADAPT! aims to create a unique interdisciplinary framework and a replicable multidimensional indicator on adaptation to EHE that empower European Union citizens to demand a safe and sustainable environment and hold institutions accountable for the adaptation process to current and upcoming risks. Este proyecto recibe financiación del programa de investigación e innovación Horizon 2020 de la Unión Europa bajo una ayuda Marie Skłodowska-Curie No. [101019424].

In general, much is known about patterns relating to flood risk reduction, coping, and adaptation in various types of communities; however, knowledge of their drivers—which are critical for building community resilience to natural hazards—is limited. The present study investigates the influencing factors of coping and adaptation measures vis-a-vis flood hazards at the community level and examines their interrelationships. This work employs a “case study” approach and analyzes two towns—St. Adolphe and Ste. Agathe—in the Red River Valley in the province of Manitoba, Canada. Data collection consisted of in-depth interviews with key informants and obtaining oral histories from the locals, along with an examination of secondary official records and documents. The results revealed that the major drivers of local-level coping and adaptation include functioning partnerships among stakeholders, strong institutional structures that facilitate interactive learning, knowledge co-production, resources sharing, communication and information sharing, and infrastructure supports. It was observed that an institutional atmosphere conducive to spontaneous network development yields diverse coping and adaptation strategies. To improve the outcomes of coping and adaptation measures, close collaboration between community-based groups and formal and quasi-formal institutions, and transparency in decision-making processes are vital.

Objective: The need to promote awareness of dementia prevention is broadly emphasized in Israel. Currently, there is no valid version of a Hebrew questionnaire to assess attitudes and beliefs related to dementia prevention. This study aimed to translate and validate the MCLHB-DRR questionnaire among the general Israeli population. Methods: A total sample of 328 participants between the ages of 50–83 years (mean = 58.7, SD = 6.9) were included in this study. Participants completed the online translated MCLHB-DRR questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were conducted to assess the questionnaire’s validity. Internal consistency was assessed using Cronbach’s alpha. Results: The EFA analysis revealed a seven-factor model with 27 items. One item related to perceived barriers and two items related to perceived severity were deleted. The CFA analysis confirmed a good model fit with the deleted items (χ2/df = 2.146, CFI = 0.930, TLI = 0.916, RMSEA = 0.049). Cronbach’s alpha values ranged from 0.61 to 0.92. Conclusions: The Hebrew MCLHB-DRR questionnaire is a valid and reliable measurement tool for assessing attitudes and beliefs related to health behaviours and lifestyle changes for dementia risk reduction in Israeli adults over the age of 50.

Background: During the first wave of the COVID-19 pandemic (April to May 2020), 6,169 Polish and 939 Italian residents were surveyed with an online questionnaire investigating socio-demographic information and personality traits (first section) as well as attitudes, position, and efficacy perceptions on the impact of lockdown (second section) and various health protection measures enforced (third section).Methods: The “health protection attitude score” (HPAS), an endpoint obtained by pooling up the answers to questions of the third section of the survey tool, was investigated by multiple linear regression models, reporting regression coefficients (RC) with 95% confidence intervals (95% CI).Results: Concerns for business and health due to COVID-19 were associated with a positive attitude toward risk reduction rules. By contrast, male sex, concerns about the reliability of information available online on COVID-19 and its prevention, along with the feeling of not being enough informed on the transmissibility/prevention of SARS-CoV-2 were associated with a negative attitude toward risk mitigation measures.Discussion: A recent literature review identified two social patterns with different features in relation to their attitude toward health protection rules against the spread of COVID-19. Factors positively associated with adherence to public health guidelines were perceived threat of COVID-19, trust in government, female sex, and increasing age. Factors associated with decreased compliance were instead underestimation of the COVID-19 risk, limited knowledge of the pandemic, belief in conspiracy theories, and political conservativism. Very few studies have tested interventions to change attitudes or behaviors.Conclusion: To improve attitude and compliance toward risk reduction norms, a key intervention is fostering education and knowledge on COVID-19 health risk and prevention among the general population. However, information on COVID-19 epidemiology might be user-generated and contaminated by social media, which contributed to creating an infodemic around the disease. To prevent the negative impact of social media and to increase adherence to health protection, stronger content control by providers of social platforms is recommended.

Dementia has a devastating impact on the quality of life of patients and families and comes with a huge cost to society. Dementia prevention is considered a public health priority by the World Health Organization. Delaying the onset of dementia by treating associated risk factors will bring huge individual and societal benefit. Empirical evidence suggests that, in higher-income countries, dementia incidence is decreasing as a result of healthier lifestyles. This observation supports the notion that preventing dementia is possible and that a certain degree of prevention is already in action. Further reduction of dementia incidence through deliberate prevention plans is needed to counteract its growing prevalence due to increasing life expectancy.An increasing number of individuals with normal cognitive performance seek help in the current memory clinics asking an evaluation of their dementia risk, preventive interventions, or interventions to ameliorate their cognitive performance. Consistent evidence suggests that some of these individuals are indeed at increased risk of dementia. This new health demand asks for a shift of target population, from patients with cognitive impairment to worried but cognitively unimpaired individuals. However, current memory clinics do not have the programs and protocols in place to deal with this new population.We envision the development of new services, henceforth called Brain Health Services, devoted to respond to demands from cognitively unimpaired individuals concerned about their risk of dementia. The missions of Brain Health Services will be (i) dementia risk profiling, (ii) dementia risk communication, (iii) dementia risk reduction, and (iv) cognitive enhancement. In this paper, we present the organizational and structural challenges associated with the set-up of Brain Health Services.

Although prevention of dementia and late-life cognitive decline is a major public health priority, there are currently no generally established prevention strategies or operational models for implementing such strategies into practice. This article is a narrative review of available evidence from multidomain dementia prevention trials targeting several risk factors and disease mechanisms simultaneously, in individuals without dementia at baseline. Based on the findings, we formulate recommendations for implementing precision risk reduction strategies into new services called Brain Health Services. A literature search was conducted using medical databases (MEDLINE via PubMed and SCOPUS) to select relevant studies: non-pharmacological multidomain interventions (i.e., combining two or more intervention domains), target population including individuals without dementia, and primary outcomes including cognitive/functional performance changes and/or incident cognitive impairment or dementia. Further literature searches covered the following topics: sub-group analyses assessing potential modifiers for the intervention effect on cognition in the multidomain prevention trials, dementia risk scores used as surrogate outcomes in multidomain prevention trials, dementia risk scores in relation to brain pathology markers, and cardiovascular risk scores in relation to dementia. Multidomain intervention studies conducted so far appear to have mixed results and substantial variability in target populations, format and intensity of interventions, choice of control conditions, and outcome measures. Most trials were conducted in high-income countries. The differences in design between the larger, longer-term trials that met vs. did not meet their primary outcomes suggest that multidomain intervention effectiveness may be dependent on a precision prevention approach, i.e., successfully identifying the at-risk groups who are most likely to benefit. One such successful trial has already developed an operational model for implementing the intervention into practice. Evidence on the efficacy of risk reduction interventions is promising, but not yet conclusive. More long-term multidomain randomized controlled trials are needed to fill the current evidence gaps, especially concerning low- and middle-income countries and integration of dementia prevention with existing cerebrovascular prevention programs. A precision risk reduction approach may be most effective for dementia prevention. Such an approach could be implemented in Brain Health Services.

Machine learning (ML) is a novel method of data analysis with potential to overcome limitations of traditional composting experiments. In this study, four ML models (multi-layer perceptron regression, support vector regression, decision tree regression, and gradient boosting regression) were integrated with genetic algorithm to predict and optimize heavy metal immobilization during composting. Gradient boosting regression performed best among the four models for predicting both heavy metal bioavailability variations and immobilization. Gradient boosting regression-based feature importance analysis revealed that the heavy metal initial bioavailability factor, total phosphorus, and composting duration were the determinant factors for heavy metal bioavailability variations (together contributing >75%). After genetic algorithm optimization, the maximum immobilization rates of Cu, Zn, Cd, As, and Cr were 79.53, 31.30, 14.91, 46.25, and 66.27%, respectively, superior to over 90% of the measured data. These findings demonstrate the potential application of ML to risk-control for heavy metals in livestock manure composting.

A correlation between low L-shell 30–100 keV electrons precipitating into the atmosphere and M ≥ 6 earthquakes in West Pacific was presented in past works where ionospheric events anticipated earthquakes by 1.5–3.5 h. This was a statistical result obtained from the Medium Energy Protons Electrons Detector on board the NOAA-15 satellite, which was analyzed for 16.5 years. The present analysis, utilizing the same database, translated into adiabatic coordinates during geomagnetic quiet periods, lead to another significant correlation regarding East Pacific strong earthquakes. This new correlation is still observed between high energy precipitating electrons detected by the NOAA-15 0° telescope and M ≥ 6 events of another very dangerous seismic region of the Pacific ring of fire. The particle precipitation that contributed to this correlation was characterized by electron L-shell, pitch-angle, possible disturbance altitudes, and geographical locations. This correlation occurred circa 57 h prior to the East Pacific earthquakes, according to past single cases of reports. The conditional probability corresponding to the cross-correlation peak of 0.024 per binary events reached a value of 0.011. A probability gain of 2 was calculated for earthquakes after an independent L-shell EBs detection, it is therefore applicable for future earthquake forecasting experiments. Moreover, a time-dependent probability gain approaching the correlation peak was estimated.

Objective:Disaster impact databases are important resources for informing research, policy, and decision making. Therefore, understanding the underpinning methodology of data collection used by the databases, how they differ, and quality indicators of the data recorded is essential in ensuring that their use as reference points is valid.Methods:The Australian Disaster Resilience Knowledge Hub (AIDRKH) is an open-source platform supported by government to inform disaster management practice. A comparative descriptive review of the Disaster Mapper (hosted at AIDRKH) and the international Emergency Events Database (EM-DAT) was undertaken to identify differences in how Australian disasters are captured and measured.Results:The results show substantial variation in identification and classification of disasters across hazard impacts and hazard types and a lack of data structure for the systematic reporting of contextual and impact variables.Conclusions:These differences may have implications for reporting, academic analysis, and thus knowledge management informing disaster prevention and response policy or plans. Consistency in reporting methods based on international classification standards is recommended to improve the validity and usefulness of this Australian database.

IntroductionFew resources address steps clinicians can take to help patients reduce their riskof dementia, despitegrowing recognition that brain health can be optimized and that risk reduction for cognitive decline can be accomplished by lifestyle modifications.MethodsTo address this gap,UsAgainstAlzheimer'sconvened a risk reduction workgroup (RRWG) to review existing evidence and develop recommendations for primary care clinicians discussing cognitive decline and risk reduction with their patients. RESULTS: The RRWG produced 11 consensus-based recommendations and implementation strategies across six topics: neurovascular risk management, physical activity, sleep, nutrition, social isolation, and cognitive stimulation. DISCUSSION: These recommendations are a first step for clinicians to address brain health with patients and potentially help them prevent cognitive decline.To ensure there is routine care for brain health,proper incentivesandpoliciesmust be institutedand more education for consumers should beprovided.

A novel bat-origin coronavirus emerged in Wuhan, China in December 2019 and continues to spread across China and the world. At the time of writing, a massive global response has been implemented to control the disease as it spreads from person to person. Yet the high-risk human-wildlife interactions and interfaces that led to the emergence of SARS-CoV and of 2019-nCoV continue to exist in emerging disease hotspots globally. To prevent the next epidemic and pandemic related to these interfaces, we call for research and investment in three areas: 1) surveillance among wildlife to identify the high-risk pathogens they carry; 2) surveillance among people who have contact with wildlife to identify early spillover events; and 3) improvement of market biosecurity regarding the wildlife trade. As the emergence of a novel virus anywhere can impact the furthest reaches of our connected world, international collaboration among scientists is essential to address these risks and prevent the next pandemic.