1,162 research outputs found
Vaccination against Foot-and-mouth disease : do initial conditions affect its benefit?
When facing incursion of a major livestock infectious disease, the decision to implement a vaccination programme is made at the national level. To make this decision, governments must consider whether the benefits of vaccination are sufficient to outweigh potential additional costs, including further trade restrictions that may be imposed due to the implementation of vaccination. However, little consensus exists on the factors triggering its implementation on the field. This work explores the effect of several triggers in the implementation of a reactive vaccination-to-live policy when facing epidemics of foot-and-mouth disease. In particular, we tested whether changes in the location of the incursion and the delay of implementation would affect the epidemiological benefit of such a policy in the context of Scotland. To reach this goal, we used a spatial, premises-based model that has been extensively used to investigate the effectiveness of mitigation procedures in Great Britain. The results show that the decision to vaccinate, or not, is not straightforward and strongly depends on the underlying local structure of the population-at-risk. With regards to disease incursion preparedness, simply identifying areas of highest population density may not capture all complexities that may influence the spread of disease as well as the benefit of implementing vaccination. However, if a decision to vaccinate is made, we show that delaying its implementation in the field may markedly reduce its benefit. This work provides guidelines to support policy makers in their decision to implement, or not, a vaccination-to-live policy when facing epidemics of infectious livestock disease
Buttressing staples with cholecyst-derived extracellular matrix (CEM) reinforces staple lines in an ex vivo peristaltic inflation model
This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ Springer Science + Business Media, LLC 2008Background - Staple line leakage and bleeding are the most common problems associated with the use of surgical staplers for gastrointestinal resection and anastomotic procedures. These complications can be reduced by reinforcing the staple lines with buttressing materials. The current study reports the potential use of cholecyst-derived extracellular matrix (CEM) in non-crosslinked (NCEM) and crosslinked (XCEM) forms, and compares their mechanical performance with clinically available buttress materials [small intestinal submucosa (SIS) and bovine pericardium (BP)] in an ex vivo small intestine model.
Methods - Three crosslinked CEM variants (XCEM0005, XCEM001, and XCEM0033) with different degree of crosslinking were produced. An ex vivo peristaltic inflation model was established. Porcine small intestine segments were stapled on one end, using buttressed or non-buttressed surgical staplers. The opened, non-stapled ends were connected to a peristaltic pump and pressure transducer and sealed. The staple lines were then exposed to increased intraluminal pressure in a peristaltic manner. Both the leak and burst pressures of the test specimens were recorded.
Results - The leak pressures observed for non-crosslinked NCEM (137.8 ± 22.3 mmHg), crosslinked XCEM0005 (109.1 ± 14.1 mmHg), XCEM001 (150.1 ± 16.0 mmHg), XCEM0033 (98.8 ± 10.5 mmHg) reinforced staple lines were significantly higher when compared to non-buttressed control (28.3 ± 10.8 mmHg) and SIS (one and four layers) (62.6 ± 11.8 and 57.6 ± 12.3 mmHg, respectively) buttressed staple lines. NCEM and XCEM were comparable to that observed for BP buttressed staple lines (138.8 ± 3.6 mmHg). Only specimens with reinforced staple lines were able to achieve high intraluminal pressures (ruptured at the intestinal mesentery), indicating that buttress reinforcements were able to withstand pressure higher than that of natural tissue (physiological failure).
Conclusions - These findings suggest that the use of CEM and XCEM as buttressing materials is associated with reinforced staple lines and increased leak pressures when compared to non-buttressed staple lines. CEM and XCEM were found to perform comparably with clinically available buttress materials in this ex vivo model.Enterprise Irelan
Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder
The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress
Multi-level evidence of an allelic hierarchy of USH2A variants in hearing, auditory processing and speech/language outcomes.
Language development builds upon a complex network of interacting subservient systems. It therefore follows that variations in, and subclinical disruptions of, these systems may have secondary effects on emergent language. In this paper, we consider the relationship between genetic variants, hearing, auditory processing and language development. We employ whole genome sequencing in a discovery family to target association and gene x environment interaction analyses in two large population cohorts; the Avon Longitudinal Study of Parents and Children (ALSPAC) and UK10K. These investigations indicate that USH2A variants are associated with altered low-frequency sound perception which, in turn, increases the risk of developmental language disorder. We further show that Ush2a heterozygote mice have low-level hearing impairments, persistent higher-order acoustic processing deficits and altered vocalizations. These findings provide new insights into the complexity of genetic mechanisms serving language development and disorders and the relationships between developmental auditory and neural systems
Evaluation of a risk-stratification strategy to improve primary care for low back pain: the MATCH cluster randomised trial protocol
Background
Despite numerous options for treating back pain and the increasing healthcare resources devoted to this problem, the prevalence and impact of back pain-related disability has not improved. It is now recognized that psychosocial factors, as well as physical factors, are important predictors of poor outcomes for back pain. A promising new approach that matches treatments to the physical and psychosocial obstacles to recovery, the STarT Back risk stratification approach, improved patients’ physical function while reducing costs of care in the United Kingdom (UK). This trial evaluates implementation of this strategy in a United States (US) healthcare setting.
Methods
Six large primary care clinics in an integrated healthcare system in Washington State were block-randomized, three to receive an intensive quality improvement intervention for back pain and three to serve as controls for secular trends. The intervention included 6 one-hour training sessions for physicians, 5 days of training for physical therapists, individualized and group coaching of clinicians, and integration of the STarT Back tool into the electronic health record. This prognostic tool uses 9 questions to categorize patients at low, medium or high risk of persistent disabling pain with recommendations about evidence-based treatment options appropriate for each subgroup. Patients at least 18 years of age, receiving primary care for non-specific low back pain, were invited to provide data 1–3 weeks after their primary care visit and follow-up data 2 months and 6 months (primary endpoint) later. The primary outcomes are back-related physical function and pain severity. Using an intention to treat approach, intervention effects on patient outcomes will be estimated by comparing mean changes at the 2 and 6 month follow-up between the pre- and post-implementation periods. The inclusion of control clinics permits adjustment for secular trends. Differences in change scores by intervention group and time period will be estimated using linear mixed models with random effects. Secondary outcomes include healthcare utilization and adherence to clinical guidelines.
Discussion
This trial will provide the first randomized trial evidence of the clinical effectiveness of implementing risk stratification with matched treatment options for low back pain in a United States health care delivery system
The dynamics of risk perceptions and precautionary behavior in response to 2009 (H1N1) pandemic influenza
<p>Abstract</p> <p>Background</p> <p>The trajectory of an infectious disease outbreak is affected by the behavior of individuals, and the behavior is often related to individuals' risk perception. We assessed temporal changes and geographical differences in risk perceptions and precautionary behaviors in response to H1N1 influenza.</p> <p>Methods</p> <p>1,290 US adults completed an online survey on risk perceptions, interests in pharmaceutical interventions (preventive intervention and curative intervention), and engagement in precautionary activities (information seeking activities and taking quarantine measures) in response to H1N1 influenza between April 28 and May 27 2009. Associations of risk perceptions and precautionary behaviors with respondents' sex, age, and household size were analyzed. Linear and quadratic time trends were assessed by regression analyses. Geographic differences in risk perception and precautionary behaviors were evaluated. Predictors of willingness to take pharmaceutical intervention were analyzed.</p> <p>Results</p> <p>Respondents from larger households reported stronger interest in taking medications and engaged in more precautionary activities, as would be normatively predicted. Perceived risk increased over time, whereas interest in pharmaceutical preventive interventions and the engagement in some precautionary activities decreased over time. Respondents who live in states with higher H1N1 incidence per population perceived a higher likelihood of influenza infection, but did not express greater interests in pharmaceutical interventions, nor did they engage in a higher degree of precautionary activities. Perceived likelihood of influenza infection, willingness to take medications and engagement in information seeking activities were higher for women than men.</p> <p>Conclusions</p> <p>Perceived risk of infection and precautionary behavior can be dynamic in time, and differ by demographic characteristics and geographical locations. These patterns will likely influence the effectiveness of disease control measures.</p
Recommended from our members
Graphene-based nanolaminates as ultra-high permeation barriers
Permeation barrier films are critical to a wide range of applications. In particular, for organic electronics and photovoltaics not only ultra-low permeation values are required but also optical transparency. A laminate structure thereby allows synergistic effects between different materials. Here, we report on a combination of chemical vapor deposition (CVD) and atomic layer deposition (ALD) to create in scalable fashion few-layer graphene/aluminium oxide-based nanolaminates. The resulting ~10 nm contiguous, flexible graphene-based films are >90% optically transparent and show water vapor transmission rates below 7 × 10¯³g/m²/day measured over areas of 5 × 5 cm². We deploy these films to provide effective encapsulation for organic light-emitting diodes (OLEDs) with measured half-life times of 880 h in ambient.We acknowledge funding via EPSRC-Innovate UK Grant (EP/M507751/1). B.C.B acknowledges funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie Grant Agreements 656214- 2DInterFOX. J.C.M. acknowledges support from the Austrian Science Fund (FWF, P25721-N20)
Development and Validation of the Behavioral Tendencies Questionnaire
At a fundamental level, taxonomy of behavior and behavioral tendencies can be described
in terms of approach, avoid, or equivocate (i.e., neither approach nor avoid). While there are
numerous theories of personality, temperament, and character, few seem to take advantage
of parsimonious taxonomy. The present study sought to implement this taxonomy by
creating a questionnaire based on a categorization of behavioral temperaments/tendencies
first identified in Buddhist accounts over fifteen hundred years ago. Items were developed
using historical and contemporary texts of the behavioral temperaments, described as
“Greedy/Faithful”, “Aversive/Discerning”, and “Deluded/Speculative”. To both maintain
this categorical typology and benefit from the advantageous properties of forced-choice
response format (e.g., reduction of response biases), binary pairwise preferences for items
were modeled using Latent Class Analysis (LCA). One sample (n1 = 394) was used to estimate
the item parameters, and the second sample (n2 = 504) was used to classify the participants
using the established parameters and cross-validate the classification against
multiple other measures. The cross-validated measure exhibited good nomothetic span
(construct-consistent relationships with related measures) that seemed to corroborate the
ideas present in the original Buddhist source documents. The final 13-block questionnaire
created from the best performing items (the Behavioral Tendencies Questionnaire or BTQ)
is a psychometrically valid questionnaire that is historically consistent, based in behavioral
tendencies, and promises practical and clinical utility particularly in settings that teach and
study meditation practices such as Mindfulness Based Stress Reduction (MBSR)
Managing diverse teams by enhancing team identification
Although diversity provides a greater pool of knowledge and perspectives, teams often do not realize the potential offered by these additional informational resources. In this study, we develop a new model seeking to explain when and how teams that are diverse in terms of educational background utilize the afforded informational variety by engaging in deeper elaboration of task-relevant information. We found that collective team identification moderated the rel
Barriers to Bystander Intervention in Sexual Harassment: The Dark Triad and Rape Myth acceptance in Indonesia, Singapore, and United Kingdom
Bystanders have an important role in preventing sexual violence, but they are often reluctant to intervene due to a range of barriers. In this study, we investigated relationships between the Dark Triad of personality (i.e. psychopathy, Machiavellianism and narcissism), rape myth acceptance and five bystander barriers. We addressed the paucity of research by collecting data from three countries (Indonesia, Singapore, and United Kingdom). In total, 716 University staff and students participated in an online survey. We found very few country-level differences in the correlations between the variables. In regression analyses, Machiavellianism and rape myth acceptance both had significant, positive relationships with failure to identify risk, failure to take responsibility, skills deficits and audience inhibition. Narcissism and psychopathy were significantly, negatively associated with audience inhibition and skills deficits. Findings indicate similarity in predictors of perceived barriers to bystander intervention across the three countries
- …