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BackgroundAcquired Brain Injuries (ABIs) can result in multiple detrimental cognitive effects, such as reduced memory capability, concentration, and planning. These effects can lead to cognitive fatigue, which can exacerbate the symptoms of ABIs and hinder management and recovery. Assessing cognitive fatigue is difficult due to the largely subjective nature of the condition and existing assessment approaches. Traditional methods of assessment use self-assessment questionnaires delivered in a medical setting, but recent work has attempted to employ more objective cognitive tests as a way of evaluating cognitive fatigue. However, these tests are still predominantly delivered within a medical environment, limiting their utility and efficacy. ObjectiveThe aim of this research was to investigate how cognitive fatigue can be accurately assessed in situ, during the quotidian activities of life. It was hypothesized that this assessment could be achieved through the use of mobile assistive technology to assess working memory, sustained attention, information processing speed, reaction time, and cognitive throughput. MethodsThe study used a bespoke smartphone app to track daily cognitive performance, in order to assess potential levels of cognitive fatigue. Twenty-one participants with no prior reported brain injuries took place in a two-week study, resulting in 81 individual testing instances being collected. The smartphone app delivered three cognitive tests on a daily basis: (1) Spatial Span to measure visuospatial working memory; (2) Psychomotor Vigilance Task (PVT) to measure sustained attention, information processing speed, and reaction time; and (3) a Mental Arithmetic Test to measure cognitive throughput. A smartphone-optimized version of the Mental Fatigue Scale (MFS) self-assessment questionnaire was used as a baseline to assess the validity of the three cognitive tests, as the questionnaire has already been validated in multiple peer-reviewed studies. ResultsThe most highly correlated results were from the PVT, which showed a positive correlation with those from the prevalidated MFS, measuring 0.342 (P

Streptococcus suis is an opportunistic bacterial porcine pathogen that can cause severe disease in humans, most commonly meningitis and sepsis (1). Human S. suis infections occur both through direct contact [...]

Background: The concept of children's rights emerged during the 1980s and emphasised the role of children as active participants in matters which concern them. Aim: This review aims to identify and synthesise the empirical evidence base on healthcare professionals' (HCPs) understanding of children's rights. Methods: Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, and the Web of Science) were systematically searched in May 2023. The Mixed Methods Appraisal Tool (MMAT) was used to quality appraise full-text papers included in the review. A descriptive narrative synthesis of the studies' findings was performed. Results: A total of 15 relevant studies from 10 countries were identified and included in the review. The number of participants included ranged from 6 to 1048 for HCPs with a broad range of sampling methods. Based on the narrative synthesis of the included studies, three main themes were identified: (1) Barriers to implementing children's rights in healthcare, (2) Factors that contribute to children's rights implementation, and (3) Study instruments used to measure outcomes. Conclusions: HCPs require a better understanding of children's rights to implement these rights into practice. Listening to children, building trusting relationships with children, and continuing professional development of HCPs could help to address barriers to understanding children's rights. There is a pressing need for the development of a tool that is capable of tracking changes in the understanding of children's rights in healthcare environments as efforts to increase awareness become more widely recognised. [ABSTRACT FROM AUTHOR]

The Aerosol Layer Height (ALH), from the Sentinel-5P/TROPOMI L2__AER_LH product, is based on an optimal estimation (OE) approach, fitting cloud-free measurements to synthetic reflectances in the strongest oxygen absorption band, provided by a neural network trained with high resolution simulated reflectances. The ALH has been continuously improved since its release in 2019, focusing especially on (bright) land surfaces, over which the ALH product showed underestimated aerosol layer heights (biased towards the surface). This paper describes the latest updates of the ALH product, that includes first the introduction of the Directional Lambertian-Equivalent Reflectance (DLER) climatology to improve the surface albedo characterisation over land. Second, the paper describes a further improvement, adding the surface albedo in the feature vector of the OE inversion, using the DLER as prior information. Using this approach, the retrievals over land largely match the retrievals over ocean, which have shown a good comparison with validation data since its release, most notably with CALIOP weighted extinction heights. The albedo is fitted for both land and ocean surfaces, but the implementation is different over land and ocean because of the large range of land surface albedos. Over land, the a priori surface albedo values are relaxed so the fitting procedure can incorporate the albedo effects in the retrieval over land. Over ocean, the retrievals are optimised by tuning the a priori error settings. The current implementation improves retrievals over land with about 1.5 times more converged results, and decreases land-ocean contrasts in the aerosol layer height retrievals. The average difference between CALIOP weighted extinction height decreased for selected cases from about −1.9 km to −0.9 km over land and from around −0.8 km to +0.1 km over ocean. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsBrain Injury Case management involves coordinating and organizing services and systems around people with acquired brain injuries’ and their families. This review aimed to answer the question: What is the current available evidence for the use of case management in supporting survivors of ABI?Searches were conducted in seven databases (Medline (all), CINAHL, Embase, PsychInfo, Scopus, Web of Science, and PubMed), using a search strategy based on key terms: ‘case management’ and ‘brain injury.’ Quality of studies was assessed by the Mixed Methods Assessment Tool (MMAT), and the Joanna Briggs Institute (JBI) checklists. Findings were presented narratively.A narrative synthesis of 35 included studies highlighted the challenges of measuring and evaluating the impact of case management for brain injury, vital aspects of case management, such as good communication and relationships, supporting the wider family, and case management across the continuum of care.Case managers play a pivotal role in the support and rehabilitation of people with ABI. The rapid evolution of case management has resulted in some challenges, such as lack of regulatory oversight and governance, and lack of standardization in treatment approaches. Future progression requires collaboration to produce better outcomes for clients and their families. [ABSTRACT FROM AUTHOR]

Streptococcus pneumoniae is an important cause of community-acquired pneumonia (CAP) in Japan. Here, we report the serotype distribution and antimicrobial susceptibility of cultured pneumococcal isolates from Japanese adults aged ≥18 years with CAP. This was a prospective, population-based, active surveillance study conducted in Goto City, Japan from December 2015 to November 2020. Pneumococcal isolates from sterile sites (blood and pleural fluid) and non-sterile sites (sputum and bronchoalveolar lavage) were cultured as part of the standard of care. S. pneumoniae were serotyped using the Quellung reaction. Antimicrobial susceptibility was tested using microdilution and interpreted according to the Clinical and Laboratory Standards Institute criteria. Isolates resistant to erythromycin were phenotyped using the triple-risk test and genotyped by polymerase chain reaction. A total of 156 pneumococcal isolates were collected (138 from sputum, 15 from blood, and 3 from bronchoalveolar lavage) from 1992 patients. Of these, 142 were non-duplicate isolates from unique patients and were included in the analyses. Serotypes contained within the 13-valent pneumococcal conjugate vaccine (PCV13) (including 6C), PCV15 (including 6C), and PCV20 (including 6C and 15C) were detected in 39 (27%), 45 (32%), and 80 (56%) of 142 isolates, respectively. The most common serotypes were 35B (12%), 11A (11%), and 3 (11%). Multidrug resistance (MDR) was detected in 96/142 (68%) isolates. Of the 96 MDR isolates, 31, 32, and 59% were PCV13, PCV15, and PCV20 serotypes, respectively; the most common MDR serotypes were 35B (16%), 6C, 10A, and 15A (9% each), and 3 and 11A (8% each). A total of 119 isolates were resistant to macrolides; 41 (35%) had an M phenotype, 53 (45%) had an iMcLS phenotype, and 25 (21%) had a cMLS phenotype. In conclusion, pneumococcal serotypes 35B, 11A and 3 were most frequently associated with pneumonia and antimicrobial resistance was common among pneumococcal isolates from adults with CAP in Goto City, Japan. Implementing higher-valency PCVs May help reduce vaccine-type CAP among Japanese adults. [ABSTRACT FROM AUTHOR]

Background: Providing care and support for a person with intellectual disabilities can be challenging and may negatively impact on family carers' health and wellbeing. A online support programme was co-designed with charitable organisations and family carers, to help meet the mental health and wellbeing needs of family carers. Objective: To test the acceptability of a newly developed online support programme for carers of people with profound and multiple intellectual disabilities. Methods: A sequential mixed-methods explanatory design was utilised. An adapted version of the Acceptability of Health Apps among Adolescents Scale was distributed to family carers across the United Kingdom and Ireland who had viewed the Carers-ID.com intervention. Participants were then invited to take part in an online interview. Qualitative and quantitative data were analysed separately and then brought together through the triangulation protocol. Results: Seventy family carers (47 female, 23 male) responded to the acceptability survey, with 10 (7 female, 3 male) taking part in interviews. Carers expressed high levels of programme acceptability (mean = 75.43 out of 88). Six themes were generated from interviews with family carers; i) time is precious, ii) the breadth and depth of module content, iii) it was somebody's experience; it was meaningful, iv) won't work for everyone, v) representation: people I could identify with, and vi) module specific suggestions for future changes. Based on our triangulation, four areas of convergence were identified: programme usability and ease, attitudes towards the programme, perceptions of effectiveness, and programme relatability. Conclusions: To be acceptable, online interventions for carers of people with intellectual disability need to be accessible, understandable and easy to use, as carers' free time can be limited. It would be important to investigate the effectiveness of online interventions for family carers, specifically considering which carers the intervention works for, and for whom it may not. [ABSTRACT FROM AUTHOR]

Background: Relationships and sexuality education (RSE) programmes are widely taught in schools, however for children and young people with intellectual disabilities, these programmes appear to be limited regarding information on relationships, informed choices and decision making. The purpose of this study was to seek the views and understanding of children and young people with intellectual disabilities, and those involved in their care and education, to identify best practice and approaches to the delivery on relationships and sexuality education. Methods: This study used a qualitative design with 37 pupils from five special schools from across the United Kingdom (UK) participating. In-depth semi-structured interviews were held online, or in person. All interviews were recorded and transcribed verbatim. Transcripts were anonymised, assigned a pseudonym and subjected to inductive thematic analysis. Findings: Four themes emerged from the data: (i) enthusiasm and inquisitiveness to acquire knowledge; (ii) dynamics of positive friendships; (iii) experiences and understanding of supportive relationships and sexuality; and (iv) valuing the exchange of knowledge and information. The findings highlight that children and young people with intellectual disabilities want education, support and information on matters relating to their relationships and sexuality. Conclusions: This is the largest study to date providing a voice to children and young people with intellectual disabilities regarding their relationships and sexuality. While special schools provide relationships and sexuality education, there is a requirement for a programme and resources specific to the needs of pupils with intellectual disabilities to be developed and evaluated. Such education should continue beyond school and be embedded in adult services. [ABSTRACT FROM AUTHOR]

Background: Despite benefits of family focused practice, little is known about health visitor's practice with families when mothers are mentally unwell. Health visitors are midwives and nurses with additional training in community public health. Objectives: To explore multiple perspectives of health visitor's family focused practice with families when mothers have mental illness in Northern Ireland. Methods: Ten health visitors, 11 mothers with mental illness and seven partners completed in-depth interviews in Five Health and Social Care Trusts. Participants were asked to describe their experiences of providing or receiving family focused practice within health visiting and data was analysed using thematic analysis. Results: Health visitors primarily addressed mothers and children's needs rather than also supporting partners. Additionally, they only addressed mother's needs associated with less severe mental illness (i.e. postnatal depression). Health visitors and mothers converged on many issues, including the influence of the health visitor's personal and professional experiences on their practice, central role of the relationship between health visitors and mothers and importance of health visitors supporting partner's well-being. While partners did not perceive that health visitors should support their well-being they expressed a need for further information and knowledge in order to support mothers. Conclusion: Health visitor's practice largely centres around mother and baby. For health visitors to increase their family focused practice they need to meet needs of mothers who have serious mental illness more effectively and consider how partners can be included in their practice, in a manner that is beneficial and acceptable to them. This study contributes to better understanding of health visitor's family focused practice with mentally ill mothers and highlights the need for more effective engagement with mothers with serious mental illness and partners. It also highlights that for health visitors to engage in family focused practice they need the necessary training and time to do so. Results can inform organisational developments in family focused practice within health visiting. [ABSTRACT FROM AUTHOR]

This systematic literature review examines the evidence base on the effectiveness of online programmes on the mental health and well-being of family carers of people with intellectual disabilities. Databases (ERIC, Medline, PsycINFO and CINAHL) were searched for intervention studies that considered online interventions for family carers of people with intellectual disabilities. Data were extracted using standardised data extraction tools. Bias was assessed using the Cochrane risk of bias tool for randomised trials (RoB 2). Screening, extraction and assessment of bias were completed independently by two members of the research team. Given the low number of included studies and different outcomes assessed within them, it was not possible to conduct a meta-analysis; therefore, data are presented narratively. Two studies met the criteria to be included in the review. Both studies utilised a feasibility randomised controlled trial methodology. One study found a significant decrease in parental stress, while the other found a significant increase in psychological well-being. Caution must be taken in drawing firm conclusions, given the small sample sizes and low retention rates in both studies. Online programmes seem to offer potential benefits to family carers of people with intellectual disabilities. However, further investigation is needed to examine these programmes, adopting a collaborative approach with family carers. [ABSTRACT FROM AUTHOR]

The Sentinel-5 Precursor (S5P) satellite operated by the European Space Agency has carried the TROPOspheric Monitoring Instrument (TROPOMI) on a Sun-synchronous low-Earth orbit since 13 October 2017. The S5P mission has acquired more than 5 years of TROPOMI nadir ozone profile data retrieved from the level 0 to 1B processor version 2.0 and the level 1B to 2 optimal-estimation-based processor version 2.4.0. The latter is described in detail in this work, followed by the geophysical validation of the resulting ozone profiles for the period May 2018 to April 2023. Comparison of TROPOMI ozone profile data to co-located ozonesonde and lidar measurements used as references concludes to a median agreement better than 5 % to 10 % in the troposphere. The bias goes up to - 15 % in the upper stratosphere (35–45 km) where it can exhibit vertical oscillations. The comparisons show a dispersion of about 30 % in the troposphere and 10 % to 20 % in the upper troposphere to lower stratosphere and in the middle stratosphere, which is close to mission requirements. Chi-square tests of the observed differences confirm on average the validity of the ex ante (prognostic) satellite and ground-based data uncertainty estimates in the middle stratosphere above about 20 km. Around the tropopause and below, the mean chi-square value increases up to about four, meaning that the ex ante TROPOMI uncertainty is underestimated. The information content of the ozone profile retrieval is characterised by about five to six vertical subcolumns of independent information and a vertical sensitivity (i.e. the fraction of the information that originates from the measurement) nearly equal to unity at altitudes from about 20 to 50 km, decreasing rapidly at altitudes above and below. The barycentre of the retrieved information is usually close to the nominal retrieval altitude in the 20–50 km altitude range, with positive and negative offsets of up to 10 km below and above this range, respectively. The effective vertical resolution of the profile retrieval usually ranges within 10–15 km, with a minimum close to 7 km in the middle stratosphere. Increased sensitivities and higher effective vertical resolutions are observed at higher solar zenith angles (above about 60°), as can be expected, and correlate with higher retrieved ozone concentrations. The vertical sensitivity of the TROPOMI tropospheric ozone retrieval is found to depend on the solar zenith angle, which translates into a seasonal and meridian dependence of the bias with respect to reference measurements. A similar although smaller effect can be seen for the viewing zenith angle. Additionally, the bias is negatively correlated with the surface albedo for the lowest three ozone subcolumns (0–18 km), despite the albedo's apparently slightly positive correlation with the retrieval degrees of freedom in the signal. For the 5 years of TROPOMI ozone profile data that are available now, an overall positive drift is detected for the same three subcolumns, while a negative drift is observed above (24–32 km), resulting in a negligible vertically integrated drift. [ABSTRACT FROM AUTHOR]

To identify and synthesise the current evidence on social participation in adults with cerebral palsy (CP). Four databases (PubMed, CINAHL Plus, PsycINFO, Web of Science) were systematically searched between December 2021 and February 2022. Pre-specified eligibility criteria were applied to all identified studies resulting in the inclusion of 16 articles. Data extraction was performed using a standardised tool and quality appraisal was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis approach was taken for data analysis. The 16 included studies were rated as high (n = 11) and medium quality (n = 5). Numbers of participants included in the studies ranged from 7 to 335. Definitions of social participation were discussed. Common themes were identified: the impact of home and work environments on social participation, the importance of age-appropriate support and interventions, and the impact of limited autonomy on social participation. Adults with CP experience limited social participation due to lack of appropriate support in childhood, issues across the lifespan including physical limitations when ageing, and factors such as societal expectations and inaccessible environments which limit opportunities for autonomy. Social participation may be improved by supporting families to provide opportunities in childhood, providing timely interventions, and by enhancing autonomy. Considering the support needs of the wider family, in order to build a supportive family environment in childhood, could improve social participation opportunities for individuals with cerebral palsy (CP) in adulthood. Social participation in adulthood may be improved by encouraging independence and autonomy in childhood and adolescence. Taking a lifespan approach to services for individuals with CP could improve social participation and better prepare them for the challenges of adulthood. [ABSTRACT FROM AUTHOR]

Next-generation pneumococcal conjugate vaccines (PCVs) have been approved for use. The serotype distribution of pneumococcal isolates can vary between regions. To understand the potential impacts of new PCVs, we evaluated trends in invasive pneumococcal disease (IPD) among adults in Germany at a local level using Bayesian hierarchical logistic regression. There was little spatial variation in IPD cases caused by 13-valent PCV serotypes, which dropped from 60% of IPD cases in 2006 to 30% in 2018. More than half of IPD cases in 2018 were attributable to serotypes covered by new PCVs (15-valent and 20-valent PCVs), which suggests they could further reduce the burden of IPD. [ABSTRACT FROM AUTHOR]

The TROPOMI XCH4 data product requires rigorous cloud filtering to achieve a product accuracy of <1%. To this end, operational XCH4 data processing has been based on SUOMI-NPP VIIRS cloud observations. However, SUOMI-NPP is nearing the end of its operational life and has encountered malfunctions in 2022 and 2023. In this study, we introduce a novel machine learning cloud-clearing approach based on a random forest classifier (RFC). The RFC is trained on collocated TROPOMI and SUOMI-NPP VIIRS data to emulate VIIRS-like cloud clearing. After training, cloud masking requires only TROPOMI data, and so becomes operationally independent of SUOMI-NPP. We demonstrate the RFC approach by applying cloud clearing to operational TROPOMI XCH4 data for August 2022, a period in which VIIRS was not operational. For validation, we analyze the TROPOMI XCH4 data at 12 TCCON stations. Comparison of cloud clearing using the RFC and the original VIIRS method reveals excellent agreement with a similar station-to-station bias (−7.4 ppb versus −5.6 ppb), a similar standard deviation of the station-to-station bias (11.6 ppb versus 12 ppb), and the same Pearson correlation coefficient of 0.9. Remarkably, the RFC cloud clearing provides a slightly higher volume of data (2182 versus 2035 daily means) and appears to have fewer outliers. Since 21 November 2023, the RFC approach is part of the operational processing chain of the European Space Agency (ESA). For now, the default practice is to utilize SNPP-VIIRS when accessible. Only in cases where VIIRS data are unavailable do we resort to the RFC cloud mask. [ABSTRACT FROM AUTHOR]