Evaluation of recreational health risk in coastal waters based on enterococcus densities and bathing patterns.

We constructed a simulation model to compute the incidences of highly credible gastrointestinal illness (HCGI) in recreational bathers at two intermittently contaminated beaches of Orange County, California. Assumptions regarding spatial and temporal bathing patterns were used to determine exposure levels over a 31-month study period. Illness rates were calculated by applying previously reported relationships between enterococcus density and HCGI risk to the exposure data. Peak enterococcus concentrations occurred in late winter and early spring, but model results showed that most HCGI cases occurred during summer, attributable to elevated number of exposures. Approximately 99% of the 95,010 illness cases occurred when beaches were open. Model runs were insensitive to 0-10% swimming activity assumed during beach closure days. Comparable illness rates resulted under clustered and uniform bather distribution scenarios. HCGI attack rates were within federal guidelines of tolerable risk when averaged over the study period. However, tolerable risk thresholds were exceeded for 27 total days and periods of at least 6 consecutive days. Illness estimates were sensitive to the functional form and magnitude of the enterococcus density-HCGI relationships. The results of this study contribute to an understanding of recreational health risk in coastal waters

A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial

Background More young people are going to university, but there is concern about an increasing demand for student mental health services. We designed a pragmatic randomised controlled trial to test the hypothesis that providing mindfulness courses to university students would promote their resilience to stress. Methods University of Cambridge students without severe mental illness or crisis (self-assessed) were remotely randomised to join an 8-week mindfulness course adapted for university students (MSS), or to mental health support as usual (SAU). The primary outcome was self-reported psychological distress during the examination period measured using the Clinical Outcomes in Routine Evaluation Outcome Measure. Main outcome intention-to-treat analysis was masked to allocation. Trial registration: ACTRN12615001160527 (complete). Findings In total, 616 students were randomised (circa 3% of all students; 309 to MSS, 307 to SAU); 74% completed the primary outcome measure; 65% of the MSS arm participants completed at least half of the MSS course. MSS reduced distress scores during the exam period compared with SAU (β=-0.44, 95%CI -0.60 to -0.29; p < 0.0001); 57% of SAU participants had distress scores above an accepted clinical threshold level compared with 37% of MSS participants. On average, six students needed to be offered the MSS course to prevent one from experiencing clinical levels of distress (number needed to treat 6, 95%CI 4 to 10). SAU distress worsened over the year whereas MSS scores improved after the course and were maintained during exams. Active monitoring revealed no adverse reactions related to self-harm, suicidality or harm to others. Interpretation The main limitation of this trial is the lack of control for non-specific effects. However, the provision of mindfulness training appears an effective component of a wider student mental health strategy. Funding University of Cambridge and NIHR Collaboration for Leadership in Applied Health Research and Care East of England.University of Cambridge and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England

Universities futureproofing youth mental health: research confirms that offering mindfulness courses to students increases their wellbeing and resilience to stress

ABSTRACT Introduction Worldwide, increasing numbers of young people go to university, but there is concern about students’ rising need for mental health services. Young people’s journey through university provides a golden yet under-used opportunity for prevention. Mindfulness meditation training is popular amongst young people, but its effectiveness to increase wellbeing and resilience to stress in university students needs confirmation. Objective To address these issues the University of Cambridge has funded an implementation and evaluation project co-produced between the University Counselling Service, the Academic Division and the Department of Psychiatry. We designed a pragmatic, randomised controlled trial assessing the impact of providing mindfulness teaching before examinations to test the main hypothesis that it reduces students’ distress. Methods University of Cambridge students without severe mental illness or related crisis were randomly allocated to join an 8-week mindfulness course adapted for university students, or to just continue accessing to mental health support as usual (SAU). The main outcome was self-reported psychological distress during the examination period measured with the CORE Outcome Measure. Other results included the Warwick-Edinburgh Mental Wellbeing Scale, and adverse events. Main outcome analysis was masked to random allocation. An Advisory Reference Group involved students and other stakeholders. An independent committee provided oversight. Results A sample of 616 students took part (median age 22 years, 63% women); 309 were allocated to mindfulness, and 307 to SAU. Participants’ initial distress was higher than the general student population, but lower than students attending counselling; 74% completed the main outcome questionnaire. During the exam season mindfulness participants’ distress score was on average 0.25 CORE-OM points lower (95% confidence interval (CI) 0.16 to 0.34) than SAU participants’ distress. This difference bridges the gap between participants’ initial distress (0.99) and the general student population mean (0.76). Mindfulness participants were one third less likely to be in the clinical range of distress than SAU participants (risk ratio 0.65, 95%CI 0.53 to 0.80). SAU participants’ distress increased over the academic year whereas mindfulness group distress decreased after the course and was maintained during the exam period. Mindfulness also increased wellbeing. Effects were extremely unlikely to be due to chance (p<0.001). Mindfulness did not cause any significant adverse events. Conclusion Findings confirm that the provision of an 8-week mindfulness course effectively reduces distress and enhances wellbeing in university students. We hope that these results will impact significantly on student welfare policy, with mindfulness being implemented at universities more widely

'Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients

Background: Footwear has been accepted as a therapeutic intervention for the foot affected by rheumatoid arthritis (RA). Evidence relating to the objective assessment of footwear in patients with RA is limited. The aims of this study were to identify current footwear styles, footwear characteristics, and factors that influence footwear choice experienced by patients with RA. Methods: Eighty patients with RA were recruited from rheumatology clinics during the summer months. Clinical characteristics, global function, and foot impairment and disability measures were recorded. Current footwear, footwear characteristics and the factors associated with choice of footwear were identified. Suitability of footwear was recorded using pre-determined criteria for assessing footwear type, based on a previous study of foot pain. Results: The patients had longstanding RA with moderate-to severe disability and impairment. The foot and ankle assessment demonstrated a low-arch profile with both forefoot and rearfoot structural deformities. Over 50% of shoes worn by patients were opentype footwear. More than 70% of patients’ footwear was defined as being poor. Poor footwear characteristics such as heel rigidity and sole hardness were observed. Patients reported comfort (17%) and fit (14%) as important factors in choosing their own footwear. Only five percent (5%) of patients wore therapeutic footwear. Conclusions: The majority of patients with RA wear footwear that has been previously described as poor. Future work needs to aim to define and justify the specific features of footwear that may be of benefit to foot health for people with RA

Temporal progression in migratory status and sexual maturation in European silver eels during downstream migration

The onset of downstream migration of European eels is accompanied by a cessation of feeding and the start of sexual maturation which stresses the link between metabolism and sexual maturation, also suggesting an important role for exercise. Exercise has been tested with eels in swim tunnels and was found to stimulate the onset of sexual maturation. In this study, we have investigated the interplay between migration and maturation in the field during the downstream migration of female silver eels. Temporal changes in migratory status and sexual maturation among silver eels of the upstream Rhine River system over 3 months of the migration season (August, September and October) were determined in biometrical parameters, plasma 17β-estradiol and calcium levels, oocyte histology and gonadal fat levels. Furthermore, the ecological relevant parameters age as determined by otolithometry and health aspects indicated by haematocrit, haemoglobin and swim-bladder parasite load were measured. Silver eels were estimated to be 14 years old. A strong temporal progression in migratory stage was shown over the months of downstream migration. Catches probably represented a mix of reproductive migrants and feeding migrants of which the ratio increased over time. Furthermore, this study confirmed our hypothesis linking the migratory stage to early maturation as indicated by enlargement of the eyes, oocyte growth and fat deposition in the oocytes, exactly the same changes as found induced by exercise but not ruling out environmental influences. Migrants show extensive fat uptake by the oocytes, probably stimulated by the swimming exercise. In addition, at least 83% of the silver eels in this spawning run may have suffered from negative effects of swim-bladder parasites on their swimming performance

Paratuberculosis sero-status and milk production, SCC and calving interval in Irish dairy herds

The objective of this study was to investigate the impact of paratuberculosis sero-status on milk yield, fat, protein, somatic cell count and calving interval in Irish dairy herds. Serum from all animals over 12 months of age (n = 2,602) in 34 dairy herds was tested for antibodies to Mycobacterium avium subsp. paratuberculosis using an ELISA. Herds were categorised by sero-status into positive, non-negative and negative, where a positive herd contained two or more positive cows, a non-negative herd contained only one positive cow and a negative herd contained no positive cows. Data at animal, parity and herd-level were analysed by multiple regression using general linear models. Positive herds (mean herd size = 129 cows) and non-negative herds (81 cows) were larger than negative herds (72 cows) (P < 0.01). Negative herds had the highest economic breeding index (EBI), while positive herds had the highest estimated breeding value (EBV) for milk yield. There was no significant effect of paratuberculosis sero-status at animal, parity or herd-level on milk yield, milk fat or protein production, somatic cell count score (SCCS) or calving interval. Negative herds tended to have a lower SCCS than positive and nonnegative herds (P = 0.087). This study only examined the effects of paratuberculosis sero-status but did not examine the clinical effects of Johne's disease at the farm or dairy industry levels

Foot pain and foot health in an educated population of adults: results from the Glasgow Caledonian University Alumni Foot Health Survey

Abstract Background Foot pain is common amongst the general population and impacts negatively on physical function and quality of life. Associations between personal health characteristics, lifestyle/behaviour factors and foot pain have been studied; however, the role of wider determinants of health on foot pain have received relatively little attention. Objectives of this study are i) to describe foot pain and foot health characteristics in an educated population of adults; ii) to explore associations between moderate-to-severe foot pain and a variety of factors including gender, age, medical conditions/co-morbidity/multi-morbidity, key indicators of general health, foot pathologies, and social determinants of health; and iii) to evaluate associations between moderate-to-severe foot pain and foot function, foot health and health-related quality-of-life. Methods Between February and March 2018, Glasgow Caledonian University Alumni with a working email address were invited to participate in the cross-sectional electronic survey (anonymously) by email via the Glasgow Caledonian University Alumni Office. The survey was constructed using the REDCap secure web online survey application and sought information on presence/absence of moderate-to-severe foot pain, patient characteristics (age, body mass index, socioeconomic status, occupation class, comorbidities, and foot pathologies). Prevalence data were expressed as absolute frequencies and percentages. Multivariate logistic and linear regressions were undertaken to identify associations 1) between independent variables and moderate-to-severe foot pain, and 2) between moderate-to-severe foot pain and foot function, foot health and health-related quality of life. Results Of 50,228 invitations distributed, there were 7707 unique views and 593 valid completions (median age [inter-quartile range] 42 [31–52], 67.3% female) of the survey (7.7% response rate). The sample was comprised predominantly of white Scottish/British (89.4%) working age adults (95%), the majority of whom were overweight or obese (57.9%), and in either full-time or part-time employment (82.5%) as professionals (72.5%). Over two-thirds (68.5%) of the sample were classified in the highest 6 deciles (most affluent) of social deprivation. Moderate-to-severe foot pain affected 236/593 respondents (39.8%). High body mass index, presence of bunions, back pain, rheumatoid arthritis, hip pain and lower occupation class were included in the final multivariate model and all were significantly and independently associated with moderate-to-severe foot pain (p < 0.05), except for rheumatoid arthritis (p = 0.057). Moderate-to-severe foot pain was significantly and independently associated lower foot function, foot health and health-related quality of life scores following adjustment for age, gender and body mass index (p < 0.05). Conclusions Moderate-to-severe foot pain was highly prevalent in a university-educated population and was independently associated with female gender, high body mass index, bunions, back pain, hip pain and lower occupational class. Presence of moderate-to-severe foot pain was associated with worse scores for foot function, foot health and health-related quality-of-life. Education attainment does not appear to be protective against moderate-to-severe foot pain

Improved change detection with nearby hands

Recent studies have suggested altered visual processing for objects that are near the hands. We present three experiments that test whether an observer’s hands near the display facilitate change detection. While performing the task, observers placed both hands either near or away from the display. When their hands were near the display, change detection performance was more accurate and they held more items in visual short-term memory (experiment 1). Performance was equally improved for all regions across the entire display, suggesting a stronger attentional engagement over all visual stimuli regardless of their relative distances from the hands (experiment 2). Interestingly, when only one hand was placed near the display, we found no facilitation from the left hand and a weak facilitation from the right hand (experiment 3). Together, these data suggest that the right hand is the main source of facilitation, and both hands together produce a nonlinear boost in performance (superadditivity) that cannot be explained by either hand alone. In addition, the presence of the right hand biased observers to attend to the right hemifield first, resulting in a right-bias in change detection performance (experiments 2 and 3)

Swimming physiology of European silver eels (Anguilla anguilla L.): energetic costs and effects on sexual maturation and reproduction

The European eel migrates 5,000–6,000 km to the Sargasso Sea to reproduce. Because they venture into the ocean in a pre-pubertal state and reproduce after swimming for months, a strong interaction between swimming and sexual maturation is expected. Many swimming trials have been performed in 22 swim tunnels to elucidate their performance and the impact on maturation. European eels are able to swim long distances at a cost of 10–12 mg fat/km which is 4–6 times more efficient than salmonids. The total energy costs of reproduction correspond to 67% of the fat stores. During long distance swimming, the body composition stays the same showing that energy consumption calculations cannot be based on fat alone but need to be compensated for protein oxidation. The optimal swimming speed is 0.61–0.67 m s−1, which is ~60% higher than the generally assumed cruise speed of 0.4 m s−1 and implies that female eels may reach the Sargasso Sea within 3.5 months instead of the assumed 6 months. Swimming trials showed lipid deposition and oocyte growth, which are the first steps of sexual maturation. To investigate effects of oceanic migration on maturation, we simulated group-wise migration in a large swim-gutter with seawater. These trials showed suppressed gonadotropin expression and vitellogenesis in females, while in contrast continued sexual maturation was observed in silver males. The induction of lipid deposition in the oocytes and the inhibition of vitellogenesis by swimming in females suggest a natural sequence of events quite different from artificial maturation protocols