Improving the Welfare of Laboratory-Housed Primates Through the Use of Positive Reinforcement Training: Practicalities of Implementation

Whilst there has been a recent increase in interest in using positive reinforcement training for laboratory-housed primates, there remains a reluctance to put into practice training programmes. Much of this reticence seems to stem from lack of expertise in the running of training programmes, and a perception that training requires a large time investment, with concurrent staff costs. The aim of this thesis was to provide practical recommendations for the use of training programmes in laboratories, providing primate users and carestaff with background information needed to successfully implement training programmes whilst improving the welfare of the animals in their care. Training was carried out with two species, cynomolgus macaques (Macaca fascicularis) and common marmosets (Callithrix jacchus) in three different research laboratories to ensure practicability was as wide ranging as possible. Training success and the time investment required were closely related to the primate's temperament, most notably an individual's willingness to interact with humans, in both common marmosets and cynomolgus macaques. Age and sex however had no effect on an individual's trainability. The training of common marmosets was more successful than that with cynomolgus macaques, possibly due to differences in early experience and socialisation. Positive reinforcement training helped both species to cope with the stress of cage change or cleaning, with the monkeys showing less anxiety-related behaviour following the training programme than before. Involving two trainers in the training process did not affect the speed at which common marmosets learned to cooperate with transport box training, but behavioural observations showed that initial training sessions with a new trainer led to animals experiencing some anxiety. This however was relatively transient. Whilst the training of common marmosets to cooperate with hand capture was possible, there seemed little benefit in doing so as the monkeys did not show a reduced behavioural or physiological stress response to trained capture as compared to hand capture prior to training. However strong evidence was found that following both training and positive human interactions the marmosets coped better with capture and stress was reduced. It is recommended that an increased use of early socialisation would benefit laboratory-housed primates, and would also help improve the success of training. Further, the time investment required shows that training is practicable in the laboratory for both species, and that positive reinforcement training is an important way of improving their welfare likely through reducing boredom and fear

GP access for inclusion health groups: perspectives and recommendations.

BACKGROUND: General practice has seen the widespread adoption of remote consulting and triage systems. There is a lack of evidence exploring how inclusion health populations have been impacted by this transformation. AIM: This study aimed to explore the post-pandemic GP access for inclusion health populations, through the lens of those with lived experience, and identify practical recommendations for improving access for this population. DESIGN & SETTING: A mixed methods study exploring the direct experience of people from inclusion health groups trying to access GP care in 13 practices in east London. METHOD: A mystery shopper exercise involving 39 in-person practice visits and 13 phone-calls were undertaken. The findings were reflected upon by a multidisciplinary stakeholder group which identified recommendations for improvements. RESULTS: Only 31% of the mystery shopper visits (n=8) resulted in registration and the offer of an appointment to see a GP for an urgent problem. None of the mystery shoppers was able to book an appointment over the phone but 10/13 felt that they would be able to register and make an appointment if they followed the receptionist's instructions. Most mystery shoppers felt respected, listened to and understood the information provided to them. Just under half of the practices (46%, n=6) received positive comments on how accessible and supportive their spaces felt.Practice and system-level recommendations were identified by the stakeholder group. CONCLUSION: Ongoing GP access issues persist for inclusion health populations. We identified practice and system level recommendations for improving access for this vulnerable population

Inclusion health patient perspectives on remote access to general practice: a qualitative study.

BACKGROUND: The COVID-19 pandemic has led to rapid and widespread adoption of remote consultations and triage-first pathways in general practice. However, there is a lack of evidence on how these changes have been perceived by patients from inclusion health groups. AIM: To explore the perspectives of individuals from inclusion health groups on the provision and accessibility of remote general practice services. DESIGN & SETTING: A qualitative study with individuals from Gypsy, Roma and Traveller communities, sex workers, vulnerable migrants, and those experiencing homelessness, recruited by Healthwatch in east London. METHOD: The study materials were co-produced with people with lived experience of social exclusion. Semi-structured interviews with 21 participants were audiorecorded, transcribed, and analysed using the framework method. RESULTS: Analysis identified barriers to access owing to lack of translation availability, digital exclusion, and a complex healthcare system, which is difficult to navigate. The role of triage and general practice in emergencies often seemed unclear to participants. Other themes identified included the importance of trust, face-to-face consultation options for ensuring safety, and the benefits of remote access, particularly in terms of convenience and saving time. Themes on reducing barriers included improving staff capacity and communication, offering tailored options and continuity of care, and simplifying care processes. CONCLUSION: The study highlighted the importance of a tailored approach for addressing the multiple barriers to care for inclusion health groups and the need for clearer and inclusive communication on the available triage and care pathways

Synchronous Multifocal Osteosarcoma: Case Report and Literature Review

Background. Multifocal osteosarcoma is usually described as the occurrence of the tumour at two or more sites in a patient without pulmonary metastases and may be synchronous or metachronous. Case report. A previously well 21-year old male, who presented with a swollen, painful right knee with no history of trauma, was found to have a high-grade osteosarcoma of the distal tibia and proximal femur. He underwent resection and prosthetic replacement of the distal femur and proximal tibia and remains well 19 months after diagnosis. Discussion. Multifocal osteosarcoma is a rare condition with a poor prognosis. There is debate about whether it represents multiple primary tumours or metastatic disease

Meckel-Gruber syndrome: An update on diagnosis, clinical management, and research advances

© 2017 Hartill, Szymanska, Sharif, Wheway and Johnson. Meckel-Gruber syndrome (MKS) is a lethal autosomal recessive congenital anomaly syndrome caused by mutations in genes encoding proteins that are structural or functional components of the primary cilium. Conditions that are caused by mutations in ciliary genes are collectively termed the ciliopathies, and MKS represents the most severe condition in this group of disorders. The primary cilium is a microtubule-based organelle, projecting from the apical surface of vertebrate cells. It acts as an "antenna" that receives and transduces chemosensory and mechanosensory signals, but also regulates diverse signaling pathways, such as Wnt and Shh, that have important roles during embryonic development. Most MKS proteins localize to a distinct ciliary compartment called the transition zone (TZ) that regulates the trafficking of cargo proteins or lipids. In this review, we provide an up-to-date summary of MKS clinical features, molecular genetics, and clinical diagnosis. MKS has a highly variable phenotype, extreme genetic heterogeneity, and displays allelism with other related ciliopathies such as Joubert syndrome, presenting significant challenges to diagnosis. Recent advances in genetic technology, with the widespread use of multi-gene panels for molecular testing, have significantly improved diagnosis, genetic counseling, and the clinical management of MKS families. These include the description of some limited genotype-phenotype correlations. We discuss recent insights into the molecular basis of disease in MKS, since the functions of some of the relevant ciliary proteins have now been determined. A common molecular etiology appears to be disruption of ciliary TZ structure and function, affecting essential developmental signaling and the regulation of secondary messengers

Choice certainty and deliberative thinking in discrete choice experiments : A theoretical and empirical investigation

The Canadian Centre for Applied Research in Cancer Control (ARCC) is funded by the Canadian Cancer Society Research Institute (2015-703549). This paper developed from discussions between Verity Watson and Dean Regier that were funded by the Peter Wall Institute of Advanced Studies, University of British Columbia. Jonathan Sicsic acknowledges funding from the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme (FP7/2007-2013) under REA grant agreement PCOFUND-GA-2013-609102, through the PRESTIGE programme coordinated by Campus France. He also benefited for this research from grants provided by the French National Institute for Cancer (Coordinator: Dr Nora Moumjid). The Health Economics Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Care Directorates. The usual disclaimer applies. We thank Aki Tsuchiya, Nicolas Krucien, Thijs Dekker, and all participants to the 5th workshop on non-market valuation for useful comments on previous drafts of the paper.Peer reviewedPostprin

Dilemma In Development, Education And Employment: An Analysis Of Zimbabwe, Tanzania And Kenya

A Zambezia journal article.1979 was a year of impending change — change that was without form or concept. Speculation was rife while planners anxiously awaited policy direction. At that time we felt the need to point out certain realities in Zimbabwe’s education and employment potentiality, and to distinguish facts from the fantasies. In this paper we have identified four major premises which underlie existing educational and employment strategies. We call these ‘conventional wisdoms’; and in them we have tried to pin down the implicit assumptions which too often are taken as ‘givens’. These conventional wisdoms can be summarized as follows: 1. Resources to satisfy the demand for education will be available when the war stops and aid flows in. 2. Education will generate the required wealth and development. 3. People are unemployed because they do not have enough education or training. 4. In the fields of education and employment all that we need to solve our development problems is more of the same