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OBJECTIVES: This is a pilot study of the Vermont Family Based Approach, an innovative health promotion program designed to address behavioral health prevention in primary care, adapted for perinatal women. We aimed to determine the acceptability of the intervention across socioeconomic strata, and to identify if participation improves perinatal mental health. METHODS: Recruitment occurred at a general obstetrics practice. Women 12–25 weeks gestation were paired with a wellness coach who administered a wellness assessment and used motivational interviewing to facilitate individualized plans based on evidence-based domains of health promotion. Participants were offered access to free, co-located wellness activities through the peripartum, and referred to behavioral health services if appropriate. RESULTS: 93 women consented; 16 Medicaid Insured women (MI) and 30 Privately Insured (PI) were randomized to the intervention. Of all activities, yoga and parenting activities were most appealing, with 58% of women attending. PI (M = 12.30, SD = 11.71) attended significantly more activities than MI (M = 3.81, SD = 12.30; p = .001). Trauma exposure was inversely associated with attendance (p = .004). Randomization to the intervention was not associated with improvements in internalizing symptoms or perceived stress at 12 months postpartum, however, attending three or more wellness activities was associated with a decrease in perceived stress between baseline and 12 months postpartum. CONCLUSION: This program appeared acceptable and engaging to women with private insurance, but less so with Medicaid. The trial failed to demonstrate improvement in internalizing scores, but of those randomized to the intervention, higher engagement was associated with decreased stress one year after giving birth.

Significance The clear need to mitigate zoonotic risk has fueled increased viral discovery in specific reservoir host taxa. We show that a combination of viral and reservoir traits can predict zoonotic virus virulence and transmissibility in humans, supporting the hypothesis that bats harbor exceptionally virulent zoonoses. However, pandemic prevention requires thinking beyond zoonotic capacity, virulence, and transmissibility to consider collective “burden” on human health. For this, viral discovery targeting specific reservoirs may be inefficient as death burden correlates with viral, not reservoir, traits, and depends on context-specific epidemiological dynamics across and beyond the human–animal interface. These findings suggest that longitudinal studies of viral dynamics in reservoir and spillover host populations may offer the most effective strategy for mitigating zoonotic risk.

The emergence of SARS-CoV-2, a coronavirus with suspected bat origins, highlights a critical need for heightened understanding of the mechanisms by which bats maintain potentially zoonotic viruses at the population level and transmit these pathogens across species. We review mechanistic models, which test hypotheses of the transmission dynamics that underpin viral maintenance in bat systems. A search of the literature identified only twenty-five mechanistic models of bat-virus systems published to date, derived from twenty-three original studies. Most models focused on rabies and related lyssaviruses (eleven), followed by Ebola-like filoviruses (seven), Hendra and Nipah-like henipaviruses (five), and coronaviruses (two). The vast majority of studies has modelled bat virus transmission dynamics at the population level, though a few nested within-host models of viral pathogenesis in population-level frameworks, and one study focused on purely within-host dynamics. Population-level studies described bat virus systems from every continent but Antarctica, though most were concentrated in North America and Africa; indeed, only one simulation model with no associated data was derived from an Asian bat-virus system. In fact, of the twenty-five models identified, only ten population-level models were fitted to data – emphasizing an overall dearth of empirically derived epidemiological inference in bat virus systems. Within the data fitted subset, the vast majority of models were fitted to serological data only, highlighting extensive uncertainty in our understanding of the transmission status of a wild bat. Here, we discuss similarities and differences in the approach and findings of previously published bat virus models and make recommendations for improvement in future work.

OBJECTIVE: Since 2002, the Klingenstein Third Generation Foundation (KTGF) has supported a network of medical student mentorship programs (MSMPs) across the United States with the explicit aim of enhancing interest in, and eventual recruitment into the field of child and adolescent psychiatry (CAP). The authors conducted a multisite, retrospective cohort analysis to examine the impact of the program on career selection, as reflected by graduation match rates into psychiatry or pediatrics. METHODS: The authors collected graduating match information (2008 – 2019) from fourteen participating medical schools (Exposed) and thirteen non-participating schools (Control). Control schools were selected based on region, comparable student body and faculty size, national standing, and rank in NIH funding. Match rates into psychiatry and pediatrics were compared between Exposed and Control groups. RESULTS: Exposed schools had significantly higher match rates into psychiatry as compared to unexposed schools (6.1% and 4.8% respectively; OR [95%CI] = 1.29 [1.18, 1.40]; X(2) = 32.036, p < 0.001). In contrast, during the same time period, exposed schools had significantly lower match rates into pediatrics than unexposed ones (11.6 and 10.5%, respectively; OR [95%CI] = 0.89 (0.83, 0.95); X(2) = 12.127, p < 0.001). These findings persisted even after adjustment for secular trends in match rates. CONCLUSIONS: Seventeen years after its inception, the KTGF medical student mentorship program network has had a positive impact on match rates into general psychiatry. Future studies will address whether these results translate to trainees’ eventual selection of careers in CAP.

Objective Since 2002, the Klingenstein Third Generation Foundation (KTGF) has supported a network of medical schools across the country with the explicit aim of enhancing interest in, and eventual recruitment into the field of child and adolescent psychiatry (CAP). An active component of the KTGF network has been its annual National Medical Student Conference (NMSC). Method The Thirteenth Annual NMSC, supported by the KTGF, was held at Stanford University on February 8 and 9, 2019. We designed a 17-item survey with five underlying themes (balance, finances, patients, systems, and stigma), intended to quantify students’ perceptions of the field of CAP. We also rated students’ prospective career choices. Surveys were electronically collected at baseline, after the NMSC, and 90 days later. Results Our baseline sample consisted of 79 students (57% women) from 14 medical schools. We found improvements over time in overall perceptions of child psychiatry (F2,206=7.5, p Conclusion An intensive, 2-day conference entirely dedicated to CAP content had salutary effects among medical students in improving their perceptions about the field, and in their reported likelihood of pursuing CAP after graduation.

Despite the global investment in One Health disease surveillance, it remains difficult and costly to identify and monitor the wildlife reservoirs of novel zoonotic viruses. Statistical models can guide sampling target prioritisation, but the predictions from any given model might be highly uncertain; moreover, systematic model validation is rare, and the drivers of model performance are consequently under-documented. Here, we use the bat hosts of betacoronaviruses as a case study for the data-driven process of comparing and validating predictive models of probable reservoir hosts. In early 2020, we generated an ensemble of eight statistical models that predicted host-virus associations and developed priority sampling recommendations for potential bat reservoirs of betacoronaviruses and bridge hosts for SARS-CoV-2. During a time frame of more than a year, we tracked the discovery of 47 new bat hosts of betacoronaviruses, validated the initial predictions, and dynamically updated our analytical pipeline. We found that ecological trait-based models performed well at predicting these novel hosts, whereas network methods consistently performed approximately as well or worse than expected at random. These findings illustrate the importance of ensemble modelling as a buffer against mixed-model quality and highlight the value of including host ecology in predictive models. Our revised models showed an improved performance compared with the initial ensemble, and predicted more than 400 bat species globally that could be undetected betacoronavirus hosts. We show, through systematic validation, that machine learning models can help to optimise wildlife sampling for undiscovered viruses and illustrates how such approaches are best implemented through a dynamic process of prediction, data collection, validation, and updating. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Better methods to predict and prevent the emergence of zoonotic viruses could support future efforts to reduce the risk of epidemics. We propose a network science framework for understanding and predicting human and animal susceptibility to viral infections. Related approaches have so far helped to identify basic biological rules that govern cross-species transmission and structure the global virome. We highlight ways to make modelling both accurate and actionable, and discuss the barriers that prevent researchers from translating viral ecology into public health policies that could prevent future pandemics.

The island nation of Madagascar is home to three endemic species of Old World Fruit Bat in the family Pteropodidae:Pteropus rufus, Eidolon dupreanum, andRousettus madagascariensis, all three of which are IUCN Red Listed under some category of threat. To inform conservation efforts to model population viability for these threatened species, as well understand the mechanisms underpinning persistence of several potentially zoonotic pathogens hosted by these bats, we here define the seasonal limits of a staggered annual birth pulse across the three species. Our field studies in central-eastern Madagascar indicate that this annual birth pulse takes place in September/October forP. rufus, November forE. dupreanum, and December forR. madagascariensis. Juvenile development periods vary across the three Malagasy pteropodids, resulting in near-synchronous weaning of pups for all species in late January-February at the height of the fruiting season for Madagascar, a pattern characteristic of most mammalian frugivores on the island. We here document the size range in morphological traits for the three Malagasy fruit bat species; these traits span the range of those known for pteropodids more broadly, withP. rufusandE. dupreanumamong the larger of recorded species andR. madagascariensisamong the smaller. All three species demonstrate subtle sexual dimorphism in observed traits with larger-bodied males vs. females. We explore seasonal variation in adult body condition by comparing observed body mass with body mass predicted by forearm length, demonstrating that pregnant females add weight during staggered gestation periods and males lose weight during the nutritionally-deficit Malagasy winter. Finally, we quantify forearm, tibia, and ear length growth rates in juvenile bats, demonstrating both faster growth and more protracted development times for the largestP. rufusspecies. The longer development period for the already-threatenedP. rufusfurther jeopardizes this species’ conservation status as human hunting of bats for subsistence is particularly detrimental to population viability during reproductive periods. The more extreme seasonal variation in the mass to forearm relationship forP. rufusmay also modulate immune function, an important consideration given these bats’ roles as reservoir hosts for several high profile viral families known to cause severe disease in humans. Our work highlights the importance of longitudinal field studies in collecting critical data for mammalian conservation efforts and human public health alike.

There is increasing interest in the role that evolution may play in current and future pandemics, but there is often also considerable confusion about the actual evolutionary predictions. This may be, in part, due to a historical separation of evolutionary and medical fields, but there is a large, somewhat nuanced body of evidence-supported theory on the evolution of infectious disease. In this review, we synthesize this evolutionary theory in order to provide a framework for clearer understanding of the key principles. Specifically, we discuss the selection acting on zoonotic pathogens' transmission rates and virulence at spillover and during emergence. We explain how the direction and strength of selection during epidemics of emerging zoonotic disease can be understood by a three Ts framework: trade-offs, transmission, and time scales. Virulence and transmission rate may trade-off, but transmission rate is likely to be favoured by selection early in emergence, particularly if maladapted zoonotic pathogens have ‘no-cost’ transmission rate improving mutations available to them. Additionally, the optimal virulence and transmission rates can shift with the time scale of the epidemic. Predicting pathogen evolution, therefore, depends on understanding both the trade-offs of transmission-improving mutations and the time scales of selection.

Identifying virus characteristics associated with the largest public health impacts on human populations is critical to informing zoonotic risk assessments and surveillance strategies. Efforts to assess “zoonotic risk” often use trait-based analyses to identify which viral and reservoir host groups are most likely to source zoonoses but have not fully addressed how and why the impacts of zoonotic viruses vary in terms of disease severity (‘virulence’), capacity to spread within human populations (‘transmissibility’), or total human mortality (‘death burden’). We analyzed trends in human case fatality rates, transmission capacities, and total death burdens across a comprehensive dataset of mammalian and avian zoonotic viruses. Bats harbor the most virulent zoonotic viruses even when compared to birds, which alongside bats, have been hypothesized to be “special” zoonotic reservoirs due to molecular adaptations that support the physiology of flight. Reservoir host groups more closely related to humans—in particular, Primates—harbor less virulent, but more highly transmissible viruses. Importantly, disproportionately high human death burden, arguably the most important metric of zoonotic risk, is not associated with any animal reservoir, including bats. Our data demonstrate that mechanisms driving death burdens are diverse and often contradict trait-based predictions. Ultimately, total human mortality is dependent on context-specific epidemiological dynamics, which are shaped by a combination of viral traits and conditions in the animal host population and across and beyond the human-animal interface. Understanding the conditions that predict high zoonotic burden in humans will require longitudinal studies of epidemiological dynamics in wildlife and human populations.Significance statementThe clear need to mitigate zoonotic risk has fueled increased viral discovery in specific reservoir host taxa. We show that a combination of viral and reservoir traits can predict zoonotic virus virulence and transmissibility in humans, supporting the hypothesis that bats harbor exceptionally virulent zoonoses. However, pandemic prevention requires thinking beyond zoonotic capacity, virulence, and transmissibility to consider collective ‘burden’ on human health. For this, viral discovery targeting specific reservoirs may be inefficient as death burden correlates with viral, not reservoir, traits, and depends on context-specific epidemiological dynamics across and beyond the human-animal interface. These findings suggest that longitudinal studies of viral dynamics in reservoir and spillover host populations may offer the most effective strategy for mitigating zoonotic risk.

Seven zoonoses — human infections of animal origin — have emerged from the Coronaviridae family in the past century, including three viruses responsible for significant human mortality (SARS-CoV, MERS-CoV, and SARS-CoV-2) in the past twenty years alone. These three viruses, in addition to two older CoV zoonoses (HCoV-229E and HCoV-NL63) are believed to be originally derived from wild bat reservoir species. We review the molecular biology of the bat-derived Alpha- and Betacoronavirus genera, highlighting features that contribute to their potential for cross-species emergence, including the use of well-conserved mammalian host cell machinery for cell entry and a unique capacity for adaptation to novel host environments after host switching. The adaptive capacity of coronaviruses largely results from their large genomes, which reduce the risk of deleterious mutational errors and facilitate range-expanding recombination events by offering heightened redundancy in essential genetic material. Large CoV genomes are made possible by the unique proofreading capacity encoded for their RNA-dependent polymerase. We find that bat-borne SARS-related coronaviruses in the subgenus Sarbecovirus, the source clade for SARS-CoV and SARS-CoV-2, present a particularly poignant pandemic threat, due to the extraordinary viral genetic diversity represented among several sympatric species of their horseshoe bat hosts. To date, Sarbecovirus surveillance has been almost entirely restricted to China. More vigorous field research efforts tracking the circulation of Sarbecoviruses specifically and Betacoronaviruses more generally is needed across a broader global range if we are to avoid future repeats of the COVID-19 pandemic.

Despite global investment in One Health disease surveillance, it remains difficult—and often very costly—to identify and monitor the wildlife reservoirs of novel zoonotic viruses. Statistical models can be used to guide sampling prioritization, but predictions from any given model may be highly uncertain; moreover, systematic model validation is rare, and the drivers of model performance are consequently under-documented. Here, we use bat hosts of betacoronaviruses as a case study for the data-driven process of comparing and validating predictive models of likely reservoir hosts. In the first quarter of 2020, we generated an ensemble of eight statistical models that predict host-virus associations and developed priority sampling recommendations for potential bat reservoirs and potential bridge hosts for SARS-CoV-2. Over more than a year, we tracked the discovery of 40 new bat hosts of betacoronaviruses, validated initial predictions, and dynamically updated our analytic pipeline. We find that ecological trait-based models perform extremely well at predicting these novel hosts, whereas network methods consistently perform roughly as well or worse than expected at random. These findings illustrate the importance of ensembling as a buffer against variation in model quality and highlight the value of including host ecology in predictive models. Our revised models show improved performance and predict over 400 bat species globally that could be undetected hosts of betacoronaviruses. Although 20 species of horseshoe bats (Rhinolophus spp.) are known to be the primary reservoir of SARS-like viruses, we find at least three-fourths of plausible betacoronavirus reservoirs in this bat genus might still be undetected. Our study is the first to demonstrate through systematic validation that machine learning models can help optimize wildlife sampling for undiscovered viruses and illustrates how such approaches are best implemented through a dynamic process of prediction, data collection, validation, and updating.

Wind energy developments are often controversial. Concerns are often raised about negative impacts on local communities, including impacts on property values. Some of these negative impacts may be offset by compensatory payments made by wind developers. Community involvement in the planning and development process may also reduce negative perceptions associated with wind facilities. However, if the development is near a border between municipalities, states, or even countries, it is often the case that one or more jurisdictions will not be involved in the process or receive compensation, but will, nonetheless, face some costs or impacts from the development. We explore exactly this situation at the border between Canada and the United States in the Thousand Islands region where a wind farm is currently operating on the Canadian border island of Wolfe Island. Using a parcel-level hedonic analysis of property sales transactions, we find that properties in New York with a view of and/or in close proximity to the turbines significantly depreciated in value after construction of the turbines while no negative impacts were observed on properties in Ontario. We highlight a number of factors that could contribute to these differences in impacts on property values, which may also explain the variation in results that currently exists in the literature.

Objective:We collected dietary records over the course of nine months to comprehensively characterize the consumption patterns of Malagasy people living in remote rainforest areas of north-eastern Madagascar.Design:The present study was a prospective longitudinal cohort study to estimate dietary diversity and nutrient intake for a suite of macronutrients, micronutrients and vitamins for 152 randomly selected households in two communities.Setting:Madagascar, with over 25 million people living in an area the size of France, faces a multitude of nutritional challenges. Micronutrient-poor staples, especially rice, roots and tubers, comprise nearly 80 % of the Malagasy diet by weight. The remaining dietary components (including wild foods and animal-source foods) are critical for nutrition. We focus our study in north-eastern Madagascar, characterized by access to rainforest, rice paddies and local agriculture.Participants:We enrolled men, women and children of both sexes and all ages in a randomized sample of households in two communities.Results:Although the Household Dietary Diversity Score and Food Consumption Score reflect high dietary diversity, the Minimum Dietary Diversity–Women indicator suggests poor micronutrient adequacy. The food intake data confirm a mixed nutritional picture. We found that the median individual consumed less than 50 % of his/her age/sex-specific Estimated Average Requirement (EAR) for vitamins A, B12, D and E, and Ca, and less than 100 % of his/her EAR for energy, riboflavin, folate and Na.Conclusions:Malnutrition in remote communities of north-eastern Madagascar is pervasive and multidimensional, indicating an urgent need for comprehensive public health and development interventions focused on providing nutritional security.

Virtual exchange refers to education programmes in which constructive communication and interaction takes place between individuals or groups from different cultural backgrounds with the support of educators or facilitators. Evaluating and Upscaling Telecollaborative Teacher Education (EVALUATE, http://www.evaluateproject.eu/) was a European policy experimentation financed by Erasmus+ which studied the impact of a telecollaborative model of virtual exchange on student teachers. Between 2017-2018, the project consortium trained teacher trainers and organised virtual exchanges which involved over 1,000 student teachers at initial teacher education institutions. This entailed students interacting and collaborating with partner classes from other countries as an integral part of one of their courses. The research team then analysed the learning gains from these exchanges using qualitative and quantitative research methodologies. They also worked with representatives from European ministries of education to understand how virtual exchange could be upscaled in teacher education across Europe. This publication presents the findings of the EVALUATE experimentation and its implications for the education of future teachers. The study found that engaging student teachers in structured online intercultural collaboration as part of their formal learning can contribute to the development of their digital-pedagogical, intercultural, and foreign language competences. It can also lead to innovation and international learning in the education of future teachers.

Pathogens originating from wildlife (zoonoses) pose a significant public health burden, comprising the majority of emerging infectious diseases. Efforts to control and prevent zoonotic disease have traditionally focused on animal-to-human transmission, or "spillover." However, in the modern era, increasing international mobility and commerce facilitate the spread of infected humans, nonhuman animals (hereafter animals), and their products worldwide, thereby increasing the risk that zoonoses will be introduced to new geographic areas. Imported zoonoses can potentially "spill back" to infect local wildlife-a danger magnified by urbanization and other anthropogenic pressures that increase contacts between human and wildlife populations. In this way, humans can function as vectors, dispersing zoonoses from their ancestral enzootic systems to establish reservoirs elsewhere in novel animal host populations. Once established, these enzootic cycles are largely unassailable by standard control measures and have the potential to feed human epidemics. Understanding when and why translocated zoonoses establish novel enzootic cycles requires disentangling ecologically complex and stochastic interactions between the zoonosis, the human population, and the natural ecosystem. In this Review, we address this challenge by delineating potential ecological mechanisms affecting each stage of enzootic establishment-wildlife exposure, enzootic infection, and persistence-applying existing ecological concepts from epidemiology, invasion biology, and population ecology. We ground our discussion in the neotropics, where four arthropod-borne viruses (arboviruses) of zoonotic origin-yellow fever, dengue, chikungunya, and Zika viruses-have separately been introduced into the human population. This paper is a step towards developing a framework for predicting and preventing novel enzootic cycles in the face of zoonotic translocations.

International audience; Virtual Exchange (VE) and local course sessions form together a complex blended learning environment. Manifold factors influence the success and the achievement of the learning aims within the online exchange and the course (O’Dowd & Ritter, 2006; Helm, 2015). One major driving factor of students’ participation and engagement in VE appears to be what students are assessed on and how this is related to the online exchange. This is our hypothesis based on the observations made after a first year of a VE project entitled Telenta (TELecollaboration, ENglish and TAsk design) (Nissen 2017). It is consistent with Biggs’ claim for an alignment of learning objectives, assessment and learning activities (Biggs & Tang, 2013), that also underpins O’Dowd’s (2010) claim for an assessment within VE that is coherent with targeted learning outcomes.Based on the first year’s observations, we partly modified and homogenised student assessment in both of the two participating partner classes - 3rd-year future primary teachers on the one side, and 4th-year future e-learning designers on the other - for the current second year of our VE. The scope of our study will be to verify our hypothesis, through an analysis and a triangulation of the data steaming from this second year of our exchange. The gathered data are three reflective questionnaires the students filled in after the different VE tasks, a final questionnaire, reflective texts, student exchanges within a secret Facebook group, teacher observations and exchanges, and 3 interviews that will be carried out on each side (6 in total) with specific regard to our hypothesis.Initial results show a decrease in dropout on the Italian side where there was no assessment for the telecollaboration last year whereas this year students could use the experience as part of a compulsory language exam. However, in France, where the project and all its components are compulsory and assessed, students continue to point out a different level of student participation between the two partner institutions, and attribute this to remaining differences in assessment on both sides.

Alcohol brief intervention (BI) in primary care (PC) is effective, but remains underutilized despite multiple efforts to increase provider-initiated BI. An alternative approach to promote BI is to prompt patients to initiate alcohol-related discussions. Little is known about the role of patients in BI delivery.To determine the characteristics of PC patients who reported initiating BI with their providers, and to evaluate the association between the initiator (patient vs provider) and drinking after a BI.In the context of clinical trial, patients (n = 267) who received BI during a PC visit reported on the manner in which the BI was initiated, readiness to change, demographics, and recent history of alcohol consumption. Drinking was assessed again at 6-months after the BI.Fifty percent of patients receiving a BI reported initiating the discussion of drinking themselves. Compared with those who reported a provider-initiated discussion, self-initiators were significantly younger (43.7 years vs 47.1 years; P = 0.03), more likely to meet Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for current major depression (24% vs 14%; P = 0.04), and more likely to report a history of alcohol withdrawal symptoms (68% vs 52%; P 0.01). Baseline readiness to change, baseline consumption rates, and current DSM-IV alcohol dependence were not different between groups. In the 2 to 3 weeks after BI, self-initiators reported greater decreases in drinks per week (5.7 vs 2.4; P = 0.02), and drinking days per week (1.0 vs 0.3; P = 0.002). At 6-month follow-up, self-initiators showed significantly greater reductions in weekly drinking compared to those whose provider initiated the BI (P = 0.002).Patient- and provider-initiated BI occurred with equal frequency, and patient-initiated BIs were associated with greater reductions in alcohol use. Future efforts to increase the BI rate in PC should include a focus on prompting patients to initiate alcohol-related discussions.

Great progress has been made in addressing global undernutrition over the past several decades, in part because of large increases in food production from agricultural expansion and intensification. Food systems, however, face continued increases in demand and growing environmental pressures. Most prominently, human-caused climate change will influence the quality and quantity of food we produce and our ability to distribute it equitably. Our capacity to ensure food security and nutritional adequacy in the face of rapidly changing biophysical conditions will be a major determinant of the next century's global burden of disease. In this article, we review the main pathways by which climate change may affect our food production systems—agriculture, fisheries, and livestock—as well as the socioeconomic forces that may influence equitable distribution.

Historically, efforts to assess ‘zoonotic risk’ have focused mainly on quantifying the potential for cross-species emergence of viruses from animal hosts. However, viruses clearly differ in relative burden, both in terms of morbidity and mortality (virulence) incurred and the capacity for sustained human-to-human transmission. Extending previously published databases, we delineated host and viral traits predictive of human mortality associated with viral spillover, viral capacity to transmit between humans following spillover and the probability of a given virus being zoonotic. We demonstrate that increasing host phylogenetic distance from humans positively correlates with human mortality but negatively correlates with human transmissibility, suggesting that the virulence induced by viruses emerging from hosts at high phylogenetic distance may limit capacity for human transmission. Our key result is that hosts most closely related to humans harbour zoonoses of lower impact in terms of morbidity and mortality, while the most distantly related hosts—in particular, order Chiroptera (bats)—harbour highly virulent zoonoses with a lower capacity for endemic establishment in human hosts. As a whole, our results emphasize the importance of understanding how zoonoses manifest in the human population and also highlight potential risks associated with multi-host transmission chains in spillover. This article is part of the theme issue ‘Dynamic and integrative approaches to understanding pathogen spillover’.

This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V.

Aims As discussed in the following literature review, the relative advantages of categorical and dimensional criteria for classifying the substance use disorders (SUDs) have been debated for many years. The scheduled revision of the Diagnostic and Statistical Manual (DSM) offers an opportunity to re-examine this question. Both categorical and dimensional approaches to diagnosis offer advantages, both may in fact be necessary for a comprehensive taxonomy. Methods One means of resolving debate about the direction to take in revising DSM-V and simultaneously of achieving maximum taxonomic utility is to include both categorical and dimensional criteria in DSM-V. This could be accomplished by first defining a set of categorical criteria, as in the previous editions of the DSM. Corresponding dimensional criteria could then be created using a more empirical methodology. In this paper we review some of the relevant literature, offer a specific proposal for a dimensional component for the DSM-V substance use disorders that also preserves the categorical definitions and suggest areas for additional research relevant the this agenda. Results There is evidence that alcohol and other forms of substance abuse and dependence are heterogeneous categories and that the SUDs can be conceptualized viably as arrayed along a continuum. Amplifying clinically derived categorical definitions with more empirically derived dimensional components to better capture this variability is a particularly important consideration for a substance use research agenda for DSM-V. Conclusion It is crucial that a dimensional approach be offered in some form in DSM-V; but it is also vital that any dimensional approach be linked to the categorical definition. The proposal offered herein provides a model for amplifying categorical definitions with a dimensional component in a way that is evolutionary and not disruptive to the existing taxonomy.

This paper presents the results of a European-wide survey regarding the practice of foreign language telecollaboration or Online Intercultural Exchange (OIE) in higher education. The survey was carried out as part of a European project, INTENT (Integrating Telecollaborative Networks into Foreign Language Higher Education) which was awarded funding by the European Commission's Lifelong Learning programme primarily to achieve more effective integration of telecollaboration in university institutions. Findings reveal the current 'state-of-the-art' of telecollaboration in Europe: an educational practice which is highly valued by educators and students who KDYHH(SHULHQFH�

Communicating and collaborating in online contexts can be quite different from face-to-face situations and requires students to acquire multiple literacies in addition to foreign language skills and intercultural communicative competence. This paper looks at how the development of multiliteracies can be included in the EFL classroom through the practice of telecollaboration, that is internet-mediated intercultural exchange. The integration of multiliteracies in the task design of the three stages of a telecollaboration project is illustrated through practical examples from an exchange which used English as a lingua franca.

This chapter describes how the social software tools that characterize Web 2.0, such as wikis and blogs, can be used as a valid substitute for more traditional Learning Management Systems in the context of e-learning and blended learning language courses. First, we will give a brief overview of how the educational arena is changing and the role social software can play in promoting these changes. Then we will describe two experimental courses carried out at the University of Padova using social software. The chapter ends with a discussion of the role of these tools in formal education. The aim of the chapter is to show how these tools allow language educators to take network-based language teaching beyond the limits of planned classroom activities, offering students new opportunities to access and produce real language in real situations.

This chapter discusses the potential of social software and Web 2.0 tools to enhance language learning in a blended learning context. It describes an English as a Foreign Language course that introduces students to several Web 2.0 tools with the aim of helping them develop their own Personal Learning Environment. As students become familiar with the almost endless opportunities for accessing and participating in authentic language on the Web today, they must also learn to find appropriate resources, filter unsuitable materials, manage this information overload, and decide which tools best suit their own learning style. The chapter argues that accompanied with the right pedagogical approach, these tools enhance learning by allowing students to engage in self-directed learning and gain skills and resources that are transferable to their informal, lifelong language learning.

Self-monitoring is recommended following brief alcohol intervention (BI). We have previously demonstrated that self-monitoring with an automated telephone system (interactive voice response; IVR) is associated with a steady reduction in alcohol consumption in the absence of BI. In this study we explore the feasibility and efficacy of IVR as a possible therapeutic enhancement for BI.We updated all providers (N= 112) in 15 primary care clinics about BI and encouraged them to do a BI with their patients whenever appropriate and to invite those patients to participate in the research project. Interested patients (N = 338) were randomized to one of four study conditions including no IVR and three groups who self-monitored for 6 months using an IVR: no feedback, feedback, and feedback plus a monetary calling incentive.The IVR proved to be a feasible method for self-monitoring. Of those invited to use the IVR, 90% initiated use and made 95% of the calls while they remained engaged with the system; more than half continued calling for the entire 6 months. Reported impact of the IVR and associated feedback on drinking awareness was high. Therapeutic results were mixed. Overall, the IVR groups reported higher consumption on the Timeline Followback (TLFB) at the 3- and 6-month follow-ups than did the no IVR group. However, because of a potential measurement confound, the TLFB may not have operated in an unbiased fashion across the four study conditions. A comparison of the feedback and no feedback IVR groups, which is independent of this confound, shows a significant therapeutic advantage of IVR with feedback.IVR is a feasible technology for behavioral self-monitoring in primary care clinics. IVR with regular feedback may be an effective therapeutic enhancement to BI.

Randomized trials examining the effects of brief alcohol interventions by primary care providers have consistently excluded individuals with alcohol dependence. The purpose of this study was to examine whether a diagnosis of alcohol dependence, according to the criteria in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, predicted differential effectiveness of a brief intervention (BI).Retrospective analyses were performed on participants (N = 326) enrolled in a randomized trial designed to examine the impact of interactive voice response following BI. All participants had received a BI from their primary care provider before enrolling in the study. Daily consumption data were collected using the Timeline Followback for the period before the BI (mean = 71 days) and for 6 months following the BI. We compared nondependent and dependent participants on a number of consumption-based outcomes.Dependent participants had significantly higher pre-BI consumption. At the index assessment (median =15 days after BI), both dependent and nondependent participants reported significant reductions in total drinks per week and drinking days per week after BI. Dependent participants significantly reduced their drinks per drinking day. After BI, dependent participants no longer differed significantly from nondependent participants on these measures. Similar decreases from before BI were observed in both groups through 6 months, although dependent participants drank on fewer days and significantly more on days on which they drank than did nondependent participants. Regression analyses showed that baseline consumption was the only significant predictor of post-BI consumption.We found no evidence that dependent participants realized less benefit on measures of alcohol consumption following a BI than nondependent participants.

Wikis are being used in educational settings more and more but they are often installed within existing institutional Learning Management Systems (LMS) and as such are private, readable and editable only with a password, or semi-public, readable but not editable without a password. What differentiates the use of social software tools such as wikis in the classroom from other traditional computer mediated communication (CMC) tools is that they enable communication between people and knowledge sharing beyond the limits of the classroom and classroom activities. This paper investigates whether or not closing a wiki limits the very potential the tool has in education. Based on a brief review of the literature on wikis in education, the first section discusses how the benefits of wikis might be greater when they are public. This is followed by a description of two courses carried out at the University of Padua, one using a semi-public wiki and the other a public wiki. The same groups of students contributed to both wikis over two semesters and conclusions on the advantages and disadvantages of using a public wiki are drawn from a qualitative analysis of the data gathered. The preliminary findings are then used to suggest that a compromise between public and private wikis in education might provide the ideal learning environment.