Kent Fire & Rescue Service Evaluation of Safe & Well Visits 2019/20

Safe and Well visits are carried out by fire services across the country, however the effectiveness of these interventions is rarely reviewed. There are two ways of evaluating the effectiveness of the intervention; one is to look for changing patterns in incident data that may be attributed to S&W visits, and the other is to assess the impact at a customer level. To date, studies undertaken in this field have tended to focus on assessing the impact of visits based on changes in incident numbers. The challenge with this method is that it is difficult to directly attribute any change in incident numbers to S&W interventions due to the huge number of additional, unmeasured variables that may have affected the number of incidents at any given time. Therefore, for this study, it was decided that a more informative evaluation would measure customers’ self-reported changes in their behaviour resulting from the visit. To supplement this, we also used staff feedback via focus groups on perceptions of the impact of visits and likelihood of behaviour change

A rapid review and meta-analysis of the asymptomatic proportion of PCR-confirmed SARS-CoV-2 infections in community settings [version 1; peer review: awaiting peer review]

Background: Cross-sectional studies indicate that up to 80% of active SARS-CoV-2 infections may be asymptomatic. However, accurate estimates of the asymptomatic proportion require systematic detection and follow-up to differentiate between truly asymptomatic and pre-symptomatic cases. We conducted a rapid review and meta-analysis of the asymptomatic proportion of PCR-confirmed SARS-CoV-2 infections based on methodologically appropriate studies in community settings. / Methods: We searched Medline and EMBASE for peer-reviewed articles, and BioRxiv and MedRxiv for pre-prints published before 25/08/2020. We included studies based in community settings that involved systematic PCR testing on participants and follow-up symptom monitoring regardless of symptom status. We extracted data on study characteristics, frequencies of PCR-confirmed infections by symptom status, and (if available) cycle threshold/genome copy number values and/or duration of viral shedding by symptom status, and age of asymptomatic versus (pre)symptomatic cases. We computed estimates of the asymptomatic proportion and 95% confidence intervals for each study and overall using random effect meta-analysis. / Results: We screened 1138 studies and included 21. The pooled asymptomatic proportion of SARS-CoV-2 infections was 23% (95% CI 16%-30%). When stratified by testing context, the asymptomatic proportion ranged from 6% (95% CI 0-17%) for household contacts to 47% (95% CI 21-75%) for non-outbreak point prevalence surveys with follow-up symptom monitoring. Estimates of viral load and duration of viral shedding appeared to be similar for asymptomatic and symptomatic cases based on available data, though detailed reporting of viral load and natural history of viral shedding by symptom status were limited. Evidence into the relationship between age and symptom status was inconclusive. / Conclusion: Asymptomatic viral shedding comprises a substantial minority of SARS-CoV-2 infections when estimated using methodologically appropriate studies. Further investigation into variation in the asymptomatic proportion by testing context, the degree and duration of infectiousness for asymptomatic infections, and demographic predictors of symptom status are warranted

Council tax valuation bands, socio-economic status and health outcome: a cross-sectional analysis from the Caerphilly Health and Social Needs Study

Council tax valuation bands (CTVBs) are a categorisation of household property value in Great Britain. The aim of the study was to assess the CTVB as a measure of socio-economic status by comparing the strength of the associations between selected health and lifestyle outcomes and CTVBs with two measures of socio-economic status: the National Statistics Socio-Economic Classification (NS-SEC) and the 2001 UK census-based Townsend deprivation index. METHODS: Cross-sectional analysis of data on 12,092 respondents (adjusted response 62.7%) to the Caerphilly Health and Social Needs Study, a postal questionnaire survey undertaken in Caerphilly county borough, south-east Wales, UK. The CTVB was assigned to each individual by matching the sampling frame to the local authority council tax register. Crude and age-gender adjusted odds ratios for each category of CTVB, NS-SEC and fifth of the ward distribution of Townsend scores were estimated for smoking, poor diet, obesity, and limiting long-term illness using logistic regression. Mean mental (MCS) and physical (PCS) component summary scores of the Short-Form SF-36 health status questionnaire were estimated in general linear models. RESULTS: There were significant trends in odds ratios across the CTVB categories for all outcomes, most marked for smoking and mental and physical health status. The adjusted odds ratio for being a smoker in the lowest versus highest CTVB category was 3.80 (95% CI: 3.06, 4.71), compared to 3.00 (95% CI: 2.30, 3.90) for the NS-SEC 'never worked and long-term unemployed' versus 'higher managerial and professional' categories, and 1.61 (95% CI: 1.42, 1.83) for the most deprived versus the least deprived Townsend fifth. The difference in adjusted mean MCS scores was 5.9 points on the scale for CTVB, 9.2 for NS-SEC and 3.2 for the Townsend score. The values for the adjusted mean PCS scores were 6.3 points for CTVB, 11.3 for NS-SEC, and 2.5 for the Townsend score. CONCLUSION: CTVBs assigned to individuals were strongly associated with the health and lifestyle outcomes modelled in this study. CTVBs are readily available for all residential properties and deserve further consideration as a proxy for socio-economic status in epidemiological studies in Great Britain

\u3ci\u3eDay to Day Eats\u3c/i\u3e: Using an Educational Blog to Extend Nutrition Education

An educational blog was created for the purposes of extending learning beyond the reach of organized classes and supplementing the core themes of the Expanded Food and Nutrition Education Program. Focus group members reacted to the format, content, visual appeal, and writing style of the blog and addressed their likelihood of reading the blog because of these elements. Their overall acceptance of the blog as a relevant source of nutrition information confirms the usefulness of this mode of social media for expanding the sharing of information beyond in-person interactions

Mutational comparison of the single-domained APOBEC3C and double-domained APOBEC3F/G anti-retroviral cytidine deaminases provides insight into their DNA target site specificities

Human APOBEC3F and APOBEC3G are double-domained deaminases that can catalyze dC→dU deamination in HIV-1 and MLV retroviral DNA replication intermediates, targeting T–C or C–C dinucleotides, respectively. HIV-1 antagonizes their action through its vif gene product, which has been shown (at least in the case of APOBEC3G) to interact with the N-terminal domain of the deaminase, triggering its degradation. Here, we compare APOBEC3F and APOBEC3G to APOBEC3C, a single-domained deaminase that can also act on both HIV-1 and MLV. We find that whereas APOBEC3C contains all the information necessary for both Vif-binding and cytidine deaminase activity in a single domain, it is the C-terminal domain of APOBEC3F and APOBEC3G that confer their target site specificity for cytidine deamination. We have exploited the fact that APOBEC3C, whilst highly homologous to the C-terminal domain of APOBEC3F, exhibits a distinct target site specificity (preferring Y–C dinucleotides) in order to identify residues in APOBEC3F that might affect its target site specificity. We find that this specificity can be altered by single amino acid substitutions at several distinct positions, suggesting that the strong dependence of APOBEC3-mediated deoxycytidine deamination on the 5′-flanking nucleotide is sensitive to relatively subtle changes in the APOBEC3 structure. The approach has allowed the isolation of APOBEC3 DNA mutators that exhibit novel target site preferences

On Breakdown Criteria for Nonvacuum Einstein Equations

The recent "breakdown criterion" result of S. Klainerman and I. Rodnianski stated roughly that an Einstein-vacuum spacetime, given as a CMC foliation, can be further extended in time if the second fundamental form and the derivative of the lapse of the foliation are uniformly bounded. This theorem and its proof were extended to Einstein-scalar and Einstein-Maxwell spacetimes in the author's Ph.D. thesis. In this paper, we state the main results of the thesis, and we summarize and discuss their proofs. In particular, we will discuss the various issues resulting from nontrivial Ricci curvature and the coupling between the Einstein and the field equations.Comment: 62 pages This version: corrected minor typos, expanded Section 6 (geometry of null cones

Thermoregulation is not impaired in breast cancer survivors during moderate-intensity exercise performed in warm and hot environments

This study aimed to assess how female breast cancer survivors (BCS) respond physiologically, hematologically, and perceptually to exercise under heat stress compared to females with no history of breast cancer (CON). Twenty‐one females (9 BCS and 12 CON [age; 54 ± 7 years, stature; 167 ± 6 cm, body mass; 68.1 ± 7.62 kg, and body fat; 30.9 ± 3.8%]) completed a warm (25℃, 50% relative humidity, RH) and hot (35℃, 50%RH) trial in a repeated‐measures crossover design. Trials consisted of 30 min of rest, 30 min of walking at 4 metabolic equivalents, and a 6‐minute walk test (6MWT). Physiological measurements (core temperature (T (re)), skin temperature (T (skin)), heart rate (HR), and sweat analysis) and perceptual rating scales (ratings of perceived exertion, thermal sensation [whole body and localized], and thermal comfort) were taken at 5‐ and 10‐min intervals throughout, respectively. Venous blood samples were taken before and after to assess; IL‐6, IL‐10, CRP, IFN‐γ, and TGF‐β(1). All physiological markers were higher during the 35 versus 25℃ trial; T (re) (~0.25℃, p = 0.002), T (skin) (~3.8℃, p  0.05). Both groups covered a greater 6MWT distance in 25 versus 35℃ (by ~200 m; p = 0.003). Nevertheless, the control group covered more distance than BCS, regardless of environmental temperature (by ~400 m, p = 0.03). Thermoregulation was not disadvantaged in BCS compared to controls during moderate‐intensity exercise under heat stress. However, self‐paced exercise performance was reduced for BCS regardless of environmental temperature