Long-term Disturbances Research Articles

Adaptive Anti-Disturbance Method for Magnetometer and INS Integration in a Road Vehicle

The integration of magnetometers and Inertial Navigation Systems (INS) is widely used in low-cost navigation systems. However, even if the system has been calibrated, random magnetic disturbances still appear in practical applications, which lead to large heading errors. To solve this problem, an adaptive anti-disturbance method to overcome random magnetic disturbance is proposed. First, disturbances are classified and analysed in detail based on actual road vehicle driving data. Then an Adaptive Robust Extend Kalman Filter (AREKF) is designed to resist sudden disturbances. However, an AREKF may accumulate errors slowly when a long-term disturbance exists. Considering this situation, this paper proposes that AREKF is used to maintain accuracy in the early stages, at the same time as the magnetometer is quickly calibrated with a Kalman filter. Then, the new magnetometer parameters are put into the AREKF to suppress long-term disturbances. Finally, cascading these two modules, not only the sudden disturbance can be overcome, but the situation of long-term disturbances can be suppressed. The results of simulation and an actual driving test show that the proposed method can effectively overcome random magnetic disturbances in both the short and long term.

Hierarchical Multilabel Segmentation for System Identification Using Historical Data

Model predictive controllers (MPC) utilize a model of the process to optimize the future trajectory using an objective function to obtain a control move plan. Any new MPC implementation requires model identification. The quality of the identified model depends on the information content of the data. Performing step tests to obtain informative data is time-consuming and may not be economical. Since the process data are stored for long-term in industries, this data can be used for identification. But this historical data contain informative data scattered among regions of insignificant variation, long-term disturbance effects, process interruptions, etc. Informative data required for identification can be mined from historical data by using appropriate machine learning techniques. This paper focuses on generating high quality data segments from historical records that can be used for identification of reliable process models for use in any model-based controller such as MPC. An interval-halving-based hierar...

The impact of climate and land-use changes on the most southerly fir forests (Abies pinsapo) in Europe

Current knowledge of climate change effects on forest ecology and species conservation should be linked to understanding of the past-time. Abies pinsapo forests constitute a model of an endangered ecosystem, highly vulnerable to ongoing warming, whose populations have been declining for centuries, while the drivers of this local depletion trend remain poorly understood. We hypothesized that long-term disturbances, both human- and natural-induced, have shaped A. pinsapo forests, contributing to these decline processes. Until today, studies using fossil pollen record to identify past climate impacts and land-use changes on A. pinsapo populations have not been done. Here, we investigate forests’ dynamics since the late Holocene (1180 cal. AD to present) in Southern Iberian Peninsula from a fossil pollen record by comparing the results obtained with climate fluctuations and land-uses changes. The pollen sequence shows a phase of stability during the Islamic Period (~1180–1400 cal. AD; ‘Medieval Climate Anomaly’), followed by increasing degradation at Christian Period concurrent with ‘Little Ice Age’ (LIA) (ca. 1487–1530 cal. AD). The Modern Period (1530–1800 cal. AD; LIA) is linked to intensive forest management, related to the naval industry. Afterwards, a progressive reduction is recorded during the Contemporary Age period (‘Industrial Period’) until ‘Recent Warming’. In short, historical severe forest management coupled with increasing aridity since LIA appear to influence A. pinsapo forest current species composition and poor structural diversity. These disturbances might be limiting the resilience of A. pinsapo forests under a climate change scenario. A selected forest management could promote a more complex forest structure.

Climate and human influence on late Holocene fire regimes in the British Virgin Islands

AbstractGlobal climate change poses significant threats to the Caribbean islands. Yet, little is known about the long-term disturbance regimes in island ecosystems. This research investigates 2000 yr of natural and anthropogenic fire disturbance through the analysis of a latitudinal transect of sediment records from coastal salt ponds in the British Virgin Islands (BVI). The two research objectives in this study are (1) to determine the fire regime history for the BVI over the last 2000 yr and (2) to explore ecological impacts from anthropogenic landscape modification pre- and post-European settlement. The magnitude of anthropogenic landscape modification, including the introduction of agriculture, was investigated through a multiproxy approach using sedimentary records of fossil pollen and charcoal. Our results suggest fire regimes from Belmont Pond, Thatch Island, and Skeleton Pond have been influenced by human activity, particularly during the postsettlement era, from 500 cal yr BP to modern. Our results suggest that fire regimes during the Medieval Climate Anomaly were responding to changes in climate via dominant atmospheric drivers. The presettlement fire regimes from these islands suggest that fires occurred every 90 to 120 yr. This research represents a significant data contribution to a region with little disturbance and vegetation data available.

Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice.

Perinatal depression is the most common obstetric complication in the United States, with prevalence rates of 15% to 20% among new mothers. Untreated, it can adversly affect the well-being of children and families throught increasing the risk for costly complications during birth and lead to deterioration of core supports, including partner relationships and social networks. Perinatal depression contributes to long-lasting, and even permanent, consequences for the physical and mental health of parents and children, including poor family functioning, increased risk of child abuse and neglect, delayed infant development, perinatal obstetric complications, challenges with breastfeeding, and costly increases in health care use. Perinatal depression can interfere with early parent-infant interaction and attachment, leading to potentially long-term disturbances in the child's physical, emotional, cognitive, and social development. Fortunately, perinatal depression is identifiable and treatable. The US Preventive Services Task Force, Centers for Medicare and Medicaid Services, and many professional organizations recommend routine universal screening for perinatal depression in women to facilitate early evidence-based treatment and referrals, if necessary. Despite significant gains in screening rates from 2004 to 2013, a minority of pediatricians routinely screen for postpartum depression, and many mothers are still not identified or treated. Pediatric primary care clinicians, with a core mission of promoting child and family health, are in an ideal position to implement routine postpartum depression screens at several well-child visits throughout infancy and to provide mental health support through referrals and/or the interdisciplinary services of a pediatric patient-centered medical home model.

T cell epigenetic remodeling and accelerated epigenetic aging are linked to long-term immune alterations in childhood cancer survivors

BackgroundCancer treatments have substantially improved childhood cancer survival but are accompanied by long-term complications, notably chronic inflammatory diseases. We hypothesize that cancer treatments could lead to long-term epigenetic changes in immune cells, resulting in increased prevalence of inflammatory diseases in cancer survivors.ResultsTo test this hypothesis, we established the epigenetic and transcriptomic profiles of immune cells from 44 childhood cancer survivors (CCS, > 16 years old) on full remission (> 5 years) who had received chemotherapy alone or in combination with total body irradiation (TBI) and hematopoietic stem cell transplant (HSCT). We found that more than 10 years post-treatment, CCS treated with TBI/HSCT showed an altered DNA methylation signature in T cell, particularly at genes controlling immune and inflammatory processes and oxidative stress. DNA methylation remodeling in T cell was partially associated with chronic expression changes of nearby genes, increased frequency of type 1 cytokine-producing T cell, elevated systemic levels of these cytokines, and over-activation of related signaling pathways. Survivors exposed to TBI/HSCT were further characterized by an Epigenetic-Aging-Signature of T cell consistent with accelerated epigenetic aging. To investigate the potential contribution of irradiation to these changes, we established two cell culture models. We identified that radiation partially recapitulated the immune changes observed in survivors through a bystander effect that could be mediated by circulating factors.ConclusionCancer treatments, in particular TBI/HSCT, are associated with long-term immune disturbances. We propose that epigenetic remodeling of immune cells following cancer therapy augments inflammatory- and age-related diseases, including metabolic complications, in childhood cancer survivors.

Biologically produced silver chloride nanoparticles from B. megaterium modulate interleukin secretion by human adipose stem cell spheroids.

Stem cell tissue constructs are likely to come into contact with silver-based nanoparticles-such as silver chloride nanoparticles (AgCl-NPs)-used as microbicidals at the implant site or in cosmetics. However, the effect of silver-based nanoparticles on 3D cell cultures with potential for tissue engineering has received little attention. Here, we examined the effect of sub-lethal doses (5, 10 and 25µg/mL, for 1, 7 and 21days) of AgCl-NPs produced by 'green' bacterial-based synthesis on spheroid 3D cultures of human adipose tissue stem cells (ASCs). Light microscopy analysis revealed that the shape and diameter of ASC spheroids remained largely unchanged after AgCl-NP treatment. Flow cytometry analysis with 7-AAD and 2',7'-dichlorofluorescein diacetate revealed no statistically significant differences in cell death but showed an increase of ROS levels for the untreated group and significant differences for the groups treated with 5 and 10µg/mL at day 7 (p = 0.0395, p = 0.0266, respectively). Electron microscopy analysis showed limited cell damage in the periphery of AgCl-NP-treated spheroids. However, treatment with AgCl-NP had statistically significant effects on the secretion of IL-6, IL-8, IL-1β and IL-10 by spheroids, at specific treatment periods and concentrations, and particularly for IL-6, IL-8 and IL-1β. TGF-β1 and -β2 secretion also changed significantly throughout the treatment period. Our results indicate that, despite having little effect on cell viability and morphology, sub-lethal AgCL-NP doses modulate ROS production at day 7 for the groups treated with 5 and 10µg/mL and also modulate the secretory profile of ASC spheroids. Thus, the use of skin implants or products containing Ag-NPs may promote long-term disturbances in subcutaneous adipose tissue homeostasis.

Multiple and Long-Term Disturbance of Gob-Side Entry Retaining by Grouped Roof Collapse and an Innovative Adaptive Technology

The demand for gob-side entry retaining (GSER) technology is extensive in Chinese coal mines because of its outstanding advantages. However, due to the occurrence of long-term roof movement disturbances, maintaining the conventional GSER over long distances is difficult. The urgent demand for this technology and its difficult maintenance are prominent contradictions faced in its application. In this paper, two characteristics of strata movement after mining that have great influence on GSER are determined in a physical simulation experiment. One is that the roof layers, which are dominated by the key strata (KS), collapse in multiple groups to form two-directional periodic pressures and superposed disturbances. The other is that the movement of the main roof will experience three stages of deformation, as follows: bending subsidence before collapse, sinking deformation at collapse and compressive deformation after collapse. In particular, the gradual compression of the bulging gangue in the gob extends the disturbance cycle. Therefore, it is difficult to maintain the GSER over long distances because of the long-term and multiple breaking disturbances of the roof layers. Mechanical models of KS breaking and GSER are established, and a method to determine the timing and strength of KS disturbances are proposed. Making use of the characteristics of staged collapse and fluctuating weighting of the overlying strata, an innovative technology named short-staged GSER is proposed. This technology maintains the maximum length of GSER within the optimal length, which ensures that the entry avoids superposed disturbances, and reduces the maintenance difficulty. The method for determining the key technical parameters is discussed, and an engineering case in panel 24202 of the Shaqu Mine in China is presented. From a back-calculation of measurements, the engineering practice demonstrates that the surrounding rock mass is stable, and the deformed entry size is safe when the length of the short-staged GSER does not exceed 100 m.

At What Scales and Why Does Forest Structure Vary in Naturally Dynamic Boreal Forests? An Analysis of Forest Landscapes on Two Continents

Identifying the scales of variation in forest structures and the underlying processes are fundamental for understanding forest dynamics. Here, we studied these scale-dependencies in forest structure in naturally dynamic boreal forests on two continents. We identified the spatial scales at which forest structures varied, and analyzed how the scales of variation and the underlying drivers differed among the regions and at particular scales. We studied three 2 km × 2 km landscapes in northeastern Finland and two in eastern Canada. We estimated canopy cover in contiguous 0.1-ha cells from aerial photographs and used scale-derivative analysis to identify characteristic scales of variation in the canopy cover data. We analyzed the patterns of variation at these scales using Bayesian scale space analysis. We identified structural variation at three spatial scales in each landscape. Among landscapes, the largest scale of variation showed the greatest variability (20.1–321.4 ha), related to topography, soil variability, and long-term disturbance history. Superimposed on this large-scale variation, forest structure varied at similar scales (1.3–2.8 ha) in all landscapes. This variation correlated with recent disturbances, soil variability, and topographic position. We also detected intense variation at the smallest scale analyzed (0.1 ha, grain of our data), partly driven by recent disturbances. The distinct scales of variation indicated hierarchical structure in the landscapes studied. Except for the large-scale variation, these scales were remarkably similar among the landscapes. This suggests that boreal forests may display characteristic scales of variation that occur somewhat independent of the tree species characteristics or the disturbance regime.

The effect of repeated cadmium oral exposure on the level of sex hormones, estrous cyclicity, and endometrium morphometry in female rats

Cadmium (Cd) is regarded as a potential endocrine disruptor. However, the exact mechanism by which this metal may interfere with the reproductive system has not yet been elucidated. The present study aimed to investigate the effect of subacute Cd oral administration at daily doses of 0.09, 1.8, and 4.5 mgCd/kg b.w. and the impact of Cd on sex hormones (estradiol (E2) and progesterone (P)) in the plasma and uterus, as well as on estrous cyclicity and histopathological changes in uterine and ovary in female rats after terminating the exposure and after a prolonged observation period (3 months). Moreover, Cd bioaccumulation in the uterine and brain tissue of rats was analyzed. The study revealed that oral Cd exposure induced changes in the plasma levels of steroid hormones: decrease in E2 and increase in P after the highest dose of Cd. Probably, for the first time, it was evidenced that circulation sex hormone disturbances in Cd-exposed rats caused irregular estrous cycle, persisting for 3 months after exposure termination; no alterations in these hormone levels in uterine tissue were noted. Cd did not induce estradiol-like hyperplasia of endometrium, but resulted in endometrial edema irrespective of the dose, and caused damage of the ovaries after the highest dose. In summary, subacute oral exposure of female rats to Cd may lead to long-term disturbances in reproductive system.

Assessing timber volume recovery after disturbance in tropical forests – A new modelling framework

One third of contemporary tropical forests is designated by national forest services for timber production. Tropical forests are also increasingly affected by anthropogenic disturbances. However, there is still much uncertainty around the capacity of tropical forests to recover their timber volume after logging as well as other disturbances such as fires, large blow-downs and extreme droughts, and thus on the long-term sustainability of logging.We developed an original Bayesian hierarchical model of Volume Dynamics with Differential Equations (VDDE) to infer the dynamic of timber volumes as the result of two ecosystem processes: volume gains from tree growth and volume losses from tree mortality. Both processes are expressed as explicit functions of the forest maturity, i.e. the overall successional stage of the forest that primarily depends on the frequency and severity of the disturbances that the forest has undergone. As a case study, the VDDE model was calibrated with data from Paracou, a long-term disturbance experiment in a neotropical forest where over 56 ha of permanent forest plots were logged with different intensities and censused for 31 years. With this model, we could predict timber recovery at Paracou at the end of a cutting cycle depending on the logging intensity, the rotation cycle length, and the proportion of commercial volume.The VDDE modelling framework developed presents three main advantages: (i) it can be calibrated with large tree inventories which are widely available from national forest inventories or logging concession management plans and are easy to measure, both on the field and with remote sensing; (ii) it depends on only a few input parameters, which can be an advantage in tropical regions where data availability is scarce; (iii) the modelling framework is flexible enough to explicitly include the effect of other types of disturbances (both natural and anthropogenic: e.g. blow-downs, fires and climate change) on the forest maturity, and thus to predict future timber provision in the tropics in a context of global changes.

Perinatal hypoxia as a risk factor for psychopathology later in life: the role of dopamine and neurotrophins.

Brain development is influenced by various prenatal, intrapartum, and postnatal events which may interact with genotype to affect the neural and psychophysiological systems related to emotions, specific cognitive functions (e.g., attention, memory), and language abilities and thereby heighten the risk for psychopathology later in life. Fetal hypoxia (intrapartum oxygen deprivation), hypoxia-related obstetric complications, and hypoxia during the early neonatal period are major environmental risk factors shown to be associated with an increased risk for later psychopathology. Experimental models of perinatal hypoxia/ischemia (PHI) showed that fetal hypoxia-a consequence common to many birth complications in humans-results in selective long-term disturbances of the dopaminergic systems that persist in adulthood. On the other hand, neurotrophic signaling is critical for pre- and postnatal brain development due to its impact on the process of neuronal development and its reaction to perinatal stress. The aim of this review is (a) to summarize epidemiological data confirming an association of PHI with an increased risk of a range of psychiatric disorders from childhood through adolescence to adulthood, (b) to present immunohistochemical findings on human autopsy material indicating vulnerability of the dopaminergic neurons of the human neonate to PHI that could predispose infant survivors of PHI to dopamine-related neurological and/or cognitive deficits in adulthood, and

Large-scale disturbance legacies and the climate sensitivity of primary Picea abies forests.

Determining the drivers of shifting forest disturbance rates remains a pressing global change issue. Large-scale forest dynamics are commonly assumed to be climate driven, but appropriately scaled disturbance histories are rarely available to assess how disturbance legacies alter subsequent disturbance rates and the climate sensitivity of disturbance. We compiled multiple tree ring-based disturbance histories from primary Picea abies forest fragments distributed throughout five European landscapes spanning the Bohemian Forest and the Carpathian Mountains. The regional chronology includes 11,595 tree cores, with ring dates spanning the years 1750-2000, collected from 560 inventory plots in 37 stands distributed across a 1,000km geographic gradient, amounting to the largest disturbance chronology yet constructed in Europe. Decadal disturbance rates varied significantly through time and declined after 1920, resulting in widespread increases in canopy tree age. Approximately 75% of current canopy area recruited prior to 1900. Long-term disturbance patterns were compared to an historical drought reconstruction, and further linked to spatial variation in stand structure and contemporary disturbance patterns derived from LANDSAT imagery. Historically, decadal Palmer drought severity index minima corresponded to higher rates of canopy removal. The severity of contemporary disturbances increased with each stand's estimated time since last major disturbance, increased with mean diameter, and declined with increasing within-stand structural variability. Reconstructed spatial patterns suggest that high small-scale structural variability has historically acted to reduce large-scale susceptibility and climate sensitivity of disturbance. Reduced disturbance rates since 1920, a potential legacy of high 19th century disturbance rates, have contributed to a recent region-wide increase in disturbance susceptibility. Increasingly common high-severity disturbances throughout primary Picea forests of Central Europe should be reinterpreted in light of both legacy effects (resulting in increased susceptibility) and climate change (resulting in increased exposure to extreme events).

Community structure explains antibiotic resistance gene dynamics over a temperature gradient in soil.

Soils are reservoirs of antibiotic resistance genes (ARGs), but environmental dynamics of ARGs are largely unknown. Long-term disturbances offer opportunities to examine microbiome responses at scales relevant for both ecological and evolutionary processes and can be insightful for studying ARGs. We examined ARGs in soils overlying the underground coal seam fire in Centralia, PA, which has been burning since 1962. As the fire progresses, previously hot soils can recover to ambient temperatures, which creates a gradient of fire impact. We examined metagenomes from surface soils along this gradient to examine ARGs using a gene-targeted assembler. We targeted 35 clinically relevant ARGs and two horizontal gene transfer-related genes (intI and repA). We detected 17 ARGs in Centralia: AAC6-Ia, adeB, bla_A, bla_B, bla_C, cmlA, dfra12, intI, sul2, tetA, tetW, tetX, tolC, vanA, vanH, vanX and vanZ. The diversity and abundance of bla_A, bla_B, dfra12 and tolC decreased with soil temperature, and changes in ARGs were largely explained by changes in community structure. We observed sequence-specific biogeography along the temperature gradient and observed compositional shifts in bla_A, dfra12 and intI. These results suggest that increased temperatures can reduce soil ARGs but that this is largely due to a concomitant reduction in community-level diversity.

Ustavnopravne posledice vanrednog stanja u Francuskoj (2015-2017)

The state of emergency which lasted for almost two years represents an unprecedented event in the constitutional history of the French Fifth Republic. In addition to being characterized by unduly long, it also debilitated judicial and parliamentary mechanism for scrutiny of the president’s powers, as well as those of police and security forces. At the same time, the executive has shown a tendency to exert scope of authority in the manner that is excessive in comparison to its constitutionally designed emergency prerogatives. Additionally, fundamental individual rights, and not only those contained in rules on guarantees of fair criminal procedure, have suffered limitations that are not easily justifiable by the need to protect the highest values of the Republic. This article is dedicated to examining the introduction of legal and factual conditions for the potential long-term disturbance of some of the basic components of the constitutional order of France.

Impacts of the conventional tillage tools and reduced tillage on the soil fertility preservation: critical review

Objective: The long-term impacts of conventional tillage through compaction, soil erosion and loss of soil fertility have led to evaluation of this system. To mitigate these problems, simplified cultivation techniques (SCT) are increasingly practiced. The objective of this review is to clarify the effects of conventional tillage and minimum tillage on soil fertility.Methodology and Results: The methodology is based on a documentary research through a synthesis and a confrontation of the researches results of different authors. It is found that, after 5 to 6 years, conventional tillage lowers the fertility of the soil and reduces its productivity. There is a diversity of SCT with convincing results. These techniques leave more agricultural residues and allow an improvement of the indicator of organic matter on the soil by reduction of the mineralization. The STC, such as zero tillage, increase soil fertility and have the potential to reduce greenhouse gas emissions. Improving soil fertility increases yield with a saving in working time. Hydraulic conductivity increases when switching from conventional tillage to direct sowing. Compared to conventional tillage, SCT provide an ideal environment for soil fertility recovery. However, the adoption of SCT and no-till is subject to a constraint on the agricultural equipment used. The design of effective equipment remains the challenge to facilitate large-scale application of SCT.Conclusion and application of results: It is noticed that conventional tillage induce long-term disturbance of soil properties and reduce fertility. Simplified cultivation techniques and particularly a direct sowing have a positive effect on the amount of soil organic matter, its density and water retention, and final production. The specific direct seeder must be designed to accompany the mechanization of these techniques.Keywords: conventional tillage, direct sowing, soil fertility, conservation agriculture.

Performance Evaluation of PV Interfaced Z-Source-Network-Based Shunt Active Power Filter

Abstract In this paper, a photovoltaic supported Z-source-inverter (ZSI)-based shunt active power filter (SAPF) is proposed for power-quality improvement. The topology has a voltage source inverter (VSI), which is connected in parallel with the point of common coupling (PCC), and is assisted by an impedance network. The Z-source network is really a distinct impedance network to facilitate interconnection between the photovoltaic (PV) power-generating system and VSI. The key features of ZSI can boost up the changeable dc voltage into any specified AC output voltage, decrease the components required, and mitigate harmonic content. The compensation capability of the SAPF mainly depends on the control scheme utilized to reference current generations. In addition, the control scheme decides a number of sensor essential and measurement practices; thus, it also estimates the cost of the topology. In this proposed system, second-order generalized integrator (SOGI) is employed to extract the reference current of SAPF. The SOGI-based control scheme uses only the measurement of the converter, and load current as the feedback signals therefore does not need voltage measurement and sensors. The proposed SAPF topology utilizes an alternative energy source having an energy storage unit to compensate the long-term current disturbances and voltage interruption and mete out the active power requirement of the utility grid. The PV-supported ZSI-based SAPF tested with various kinds of loads can examine the performance of the system under steady and dynamic state conditions. To verify the effectiveness of the proposed control scheme and PV-supported SAPF topology, the simulation and experimental results are presented.

Effects of Long-Term Anthropogenic Disturbance on the Benthic Episammic Diatom Community of an Ancient, Tropical Lake.

Habitat homogenization, nutrient enrichment and loss of biodiversity are broadly recognized as the consequences of human activity in aquatic systems. Diatoms (Bacillariophyceae) are frequently used in aquatic environmental assessment and impact monitoring, but in unique habitats dominated by endemic taxa, traditional approaches may not be appropriate. We examined the impacts of long term anthropogenic impacts upon the littoral episammic diatom community around the town of Soroako, located on Lake Matano, an ancient tropical lake. Lake Matano is located on central Sulawesi Island, Indonesia, and socio-economic conditions are typical of developing nations. Although differences in nutrient concentrations were undetectable with field-based spectroscopy approaches, mean Shannon diversity was decreased in association with proximity the town-site. However, mean ß-diversity was maintained despite several decades of shoreline modification at Soroako. Elevated abundances of early-successional diatom taxa in the disturbed area drove differences between areas immediately offshore of Soroako and those farther away. These findings suggest that increased physical disturbance and TSS loads around Soroako, rather than increased nutrient loading, influenced shifts in the diatom community. These results suggest that microscopy-based biomonitoring approaches are sensitive indicators of environmental modification that could be useful in areas where access to cutting-edge analytical equipment is limited.

Mental health promotion in the wake of natural disaster

Significant psychological trauma to victims is an unavoidable by-product of severe natural disasters, and Hurricane Matthew is no exception. Making landfall on the 4th of October 2016, it swept across Haiti and eastern Cuba before reaching coastal regions of Florida, Georgia, and South Carolina. Despite Matthew’s far-reaching impact, it was in Haiti where the Category Four hurricane made its greatest mark. Infrastructure damage led to water contamination and cholera outbreaks, sparking major concern amongst the World Health Organization and Haitian Ministry of Health. Consequently, physical health impact related to cholera control through clean water access was prioritized over psychological repercussions. In this article, we aim to provide recommendations for local organizations to deliver effectively psychological intervention to Haitian victims of Matthew. We focused on Global Trauma Research, one of few humanitarian agencies with an established framework for implementing psychological trauma relief efforts, and wish to use it as the basis of our suggestions. In order to do so, we chose to review mental health promotion in the context of a relevant historical precedent, Hurricane Katrina. We uncovered a two-pronged approach taken by Hurricane Katrina responders: identification of at-risk groups followed by provision of targeted-relief efforts, and widespread delivery of care to all affected populations, with an emphasis on community reintegration. Based on these general principles, we recommend that Global Trauma Research identify groups at risk of long-term emotional disturbance, provide relief in a targeted fashion on the basis of relative need, and place emphasis on Haitian citizen support through relocation and community integration.

Anorectal malformation & Hirschsprung’s disease: A cross-sectional comparison of quality of life and bowel function to healthy controls

BackgroundPatients with anorectal malformation (ARM) and Hirschsprung’s disease (HD) face long-term disturbance in bowel function even after definitive surgery. This study evaluates the quality of life (QOL) of patients with ARM and HD, and compares them to healthy controls using self-report questionnaires. MethodologyA prospective study was performed recruiting patients with ARM or HD from September 2013 to December 2014 who had primary surgery done in our institution at least 2 years prior to participation. Age-matched and gender-matched controls were enrolled from our patients with minor outpatient complaints. All participants completed the following PedsQL™ scales (maximum score 100): 4.0 Generic Core Scales, 3.0 General Well-Being (GWB) Scale and 2.0 Family Impact (FI) Module. All were also scored on bowel function (BFS), with a maximum score 20. Appropriate statistical analysis was performed, with significance level <0.05. ResultsThere were 193 participants: 87 controls, 62 ARM, 44 HD. When comparing Core, GWB and FI scores, there were no significant differences between groups although controls had best scores indicating best QOL and general wellbeing, with least impact of the child’s health on the family. BFS was significantly different with controls having best and ARM worst scores. There were no significant differences in scores between parent and child indicating intradyad consistency. There was significant positive correlation between BFS and Core (p<0.0001), and between BFS and GWB scores (p<0.005); and significant negative correlation between BFS and FI scores (p<0.0001). ConclusionsBowel function impacts quality of life. Those with ARM and HD can achieve good quality of life comparable to controls, based on patient and caregiver self-reported outcomes. Type of studyProspective comparative study Level of evidenceLevel II.