Sure Start Blacon reach report, April 2004 - March 2005

This project report discusses Sure Start computerised records (covering personal details of all registrations within the Sure Start programme and records of each serivce and which service users have accessed them) which allow the 'reach' of the local programme across Blacon to be established between 1 April 2004 and 31 March 2005

Arterial spin labelling reveals an abnormal cerebral perfusion pattern in Parkinson's disease

There is a need for objective imaging markers of Parkinson's disease status and progression. Positron emission tomography and single photon emission computed tomography studies have suggested patterns of abnormal cerebral perfusion in Parkinson's disease as potential functional biomarkers. This study aimed to identify an arterial spin labelling magnetic resonance-derived perfusion network as an accessible, non-invasive alternative. We used pseudo-continuous arterial spin labelling to measure cerebral grey matter perfusion in 61 subjects with Parkinson's disease with a range of motor and cognitive impairment, including patients with dementia and 29 age- and sex-matched controls. Principal component analysis was used to derive a Parkinson's disease-related perfusion network via logistic regression. Region of interest analysis of absolute perfusion values revealed that the Parkinson's disease pattern was characterized by decreased perfusion in posterior parieto-occipital cortex, precuneus and cuneus, and middle frontal gyri compared with healthy controls. Perfusion was preserved in globus pallidus, putamen, anterior cingulate and post- and pre-central gyri. Both motor and cognitive statuses were significant factors related to network score. A network approach, supported by arterial spin labelling-derived absolute perfusion values may provide a readily accessible neuroimaging method to characterize and track progression of both motor and cognitive status in Parkinson's diseas

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Comparison of Self-Reports and Clinicians' Ratings of Unipolar Major Depression

Recent literature has unfavorably compared self-report measures of depression to clinician-administered measures such as the Hamilton Rating Scale. In the present study, the Beck Depression Inventory and the MMPI D scale were compared to the Hamilton Rating Scale to assess the effectiveness of each measure in discriminating unipolar depressed psychiatric inpatients ( n = 26) from inpatients without a major affective disorder ( n = 11). Scores on the Beck scale and the MMPI Depression scale but not the Hamilton Rating Scale were significantly related to the diagnosis of unipolar major depression. </jats:p

MMPI Results Associated with Abnormal Responses to the DST and TRH Tests

In the present study, it was predicted that psychiatric inpatients who obtained abnormal responses on the Dexamethasone Suppression Test (DST) and the Thyrotropin Releasing Hormone Stimulation Test (TRH) would obtain higher elevations on the MMPI scales associated with depressive symptomatology than inpatients with normal DST and TRH responses. Patients with abnormal DST responses obtained significantly lower scores on the F, Psychopathic Deviate, and Paranoia scales, suggesting that they present themselves on the MMPI as less socially maladjusted, and less alienated from societal values than their depressed inpatient peers who obtained normal DST results. No differences were obtained between abnormal and normal responders on either the DST or TRH with respect to the MMPI scales that are typically associated with depression. </jats:p

Disease surveillance of the amphibian chytrid fungus Batrachochytrium dendrobatidis in Papua New Guinea

Emerging infectious diseases threaten the persistence of biodiversity globally. The amphibian chytrid fungus, Batrachochytrium dendrobatidis, is one of the most widespread and damaging pathogens to biodiversity. New Guinea hosts 6% of the world's frogs and is the largest landmass where B. dendrobatidis remains undetected despite being largely climatically suitable for its persistence. We surveyed for B. dendrobatidis in Papua New Guinea, by swabbing live frogs in the Gulf Province and Eastern Highlands Province and by examining museum specimens from a range of sites and elevations. Here, we show that over a large geographical range, all 442 samples were negative for B. dendrobatidis. The spread of B. dendrobatidis to Papua New Guinea may have been thus far prevented by the remoteness of New Guinea and the hotter climate in its lowlands, which surrounds a more climatically suitable zone for B. dendrobatidis in the highlands. Alternatively, B. dendrobatidis may be present in isolated patches or at low levels and remain undetected, to date. Papua New Guinea remains at risk and would benefit from a national disease surveillance program for chytrid fungi and pre‐emptive actions, designed to reduce the risk of pathogen transmission. Measures should include improved biosecurity protocols for trade and travel and continued disease surveillance in areas of probable entry and spread

Disease surveillance of the amphibian chytrid fungusBatrachochytrium dendrobatidisin Papua New Guinea

Emerging infectious diseases threaten the persistence of biodiversity globally. The amphibian chytrid fungus, Batrachochytrium dendrobatidis, is one of the most widespread and damaging pathogens to biodiversity. New Guinea hosts 6% of the world's frogs and is the largest landmass where B. dendrobatidis remains undetected despite being largely climatically suitable for its persistence. We surveyed for B. dendrobatidis in Papua New Guinea, by swabbing live frogs in the Gulf Province and Eastern Highlands Province and by examining museum specimens from a range of sites and elevations. Here, we show that over a large geographical range, all 442 samples were negative for B. dendrobatidis. The spread of B. dendrobatidis to Papua New Guinea may have been thus far prevented by the remoteness of New Guinea and the hotter climate in its lowlands, which surrounds a more climatically suitable zone for B. dendrobatidis in the highlands. Alternatively, B. dendrobatidis may be present in isolated patches or at low levels and remain undetected, to date. Papua New Guinea remains at risk and would benefit from a national disease surveillance program for chytrid fungi and pre‐emptive actions, designed to reduce the risk of pathogen transmission. Measures should include improved biosecurity protocols for trade and travel and continued disease surveillance in areas of probable entry and spread