How Has the COVID-19 Pandemic Affected the Way We Access and Interact with the Countryside and the Animals within It?

SIMPLE SUMMARY: In March 2020, the UK entered its first mandatory lockdown to reduce the spread of COVID-19. The restrictions associated with the lockdown led to changes in human behaviour, particularly in relation to exercise and accessing the outdoors. This study used an online survey of UK residents to explore these changes and to understand how people interacted with the natural world while they were outside, including interactions with wildlife and domestic animals. There was an increase in how often respondents went for walks outside during lockdown, compared to pre-lockdown levels, and this increase lasted beyond the end of the first lockdown. Interacting with animals was a common feature of walks. This most commonly involved watching wildlife or domestic animals, such as livestock or horses, but sometimes also involved physically interacting with them and/or feeding them which may have implications for their welfare, for example, if inappropriate food is provided. There is also a risk of humans transferring disease between the animals they have contact with or zoonotic disease transmission between the humans and animals. While is it positive that people are interacting with the natural world, it is important that this does not compromise animal wellbeing. ABSTRACT: There is growing evidence that the changes in human behaviour resulting from the COVID-19 pandemic have had positive and negative impacts on the natural world. This study used an online survey to explore how the first UK lockdown affected human exercising behaviour, with particular focus on the role of wild and domestic animals. The survey was completed by 308 respondents. There was a significant increase in the frequency that respondents went for walks outdoors during lockdown, in comparison to pre-lockdown levels (p ≤ 0.001), and this was sustained (albeit to a lesser extent) once lockdown ended (p = 0.005). Engaging with the natural world was an important feature of walks outside for 81% of respondents. A small proportion of respondents reported physically interacting with the animals they encountered and/or feeding them, which may have implications for their welfare. The findings suggest that those who value animal encounters during their time outside always seek these interactions, while those who do not, did not tend to change this behaviour following lockdown. Should the changes in human exercising behaviour be sustained, it is important to balance the benefits of walking outdoors for human health and wellbeing with the health and welfare of the animals they encounter

Longitudinal association of conduct and emotional problems with school exclusion and truancy: A fixed effect analysis of the UK Millennium Cohort Study

BACKGROUND: There is a need for causally stronger research on the association between child mental health and school exclusion and truancy. This study examines school exclusion and truancy in relation to both conduct and emotional problems and considers these problems both as predictors and as outcomes of school exclusion and truancy. METHOD: The sample included 15,236 individuals from the Millennium Cohort Study, a UK longitudinal birth cohort study. Conduct and emotional problems were assessed from childhood to adolescence (age 7, 11, 14 and 17 years), and reports of school exclusion and truancy were collected at age 11 and 14. Fixed effect analyses were used. RESULTS: Increases in conduct problems and emotional symptoms were associated with subsequent exclusion (OR 1.22, [95% CI 1.08-1.37] and OR 1.16, [1.05-1.29], respectively). Emotional symptoms, but not conduct problems, predicted truancy (OR 1.17, [1.07-1.29]). These estimates were similar for males and females. Exclusion was associated with an increase in conduct problems at age 14 (0.50, [0.30-0.69]), and for males, it was associated with an increase in emotional symptoms both at age 14 (0.39, [0.12-0.65]) and 17 (0.43, [0.14-0.72]). Truancy was associated with an increase in conduct problems at age 14 (0.41, [0.28-0.55]), and for females also at age 17 (0.22, [0.03-0.42]), and it was associated with increased emotional symptoms at age 14 (0.43, [0.25-0.62]) and 17 (0.44, [0.21-0.66]), which was similar for males and females. CONCLUSION: Results indicate a bidirectional association between emotional symptoms and school exclusion and truancy, as an increase in these symptoms was associated with later truancy and exclusion, and emotional symptoms increased following both school events. For conduct problems, the association was bidirectional for school exclusion, but unidirectional for truancy as these symptoms did not lead to truancy, but an increase in conduct problems was observed after both exclusion and truancy

Priority setting in international trade – application of multiple criteria decision analysis for Australian-Indonesia trade in the health sector.

We demonstrate a use case of Multiple Criteria Decision Analysis (MCDA) in collaboration with industry stakeholders in forums as a way in which governments can undertake a 'soft' industry policy in international trade given the complex and changing global environment, and facilitate, rather than steer, the prioritisation of sector-specific facilitation. International trade is increasingly a balancing act with multiple competing objectives including security with open competition, economic growth with inclusion, and social and environmental protection. Post-pandemic, government efforts to stimulate export-led recovery and refine trade priorities within the rule bound by members of the World Trade Organisation are set to ramp up. To assist governments, guide their limited resources we advocate for the use of MCDA to assist with greater trade policy transparency and enable strategic decision making between multiple stakeholders While MCDA is often used in areas such as healthcare and environmental resourcing, it is not widely used in international trade. We demonstrate the use of MCDA to determine potential trade priorities in the healthcare sector under the Indonesia-Australia Comprehensive Economic Partnership Agreement. MCDA was applied in real-time during online workshops hosted by Australia's Department of Foreign Affairs and Trade with 38 industry stakeholders. The pilot determined clear priorities for trade promotion in a transparent process. These are discussed along with the potential to further develop and apply MCDA and the limitations of the analysis for effective use in international trade

Scoping review of end-of-life decision-making models used in dogs, cats and equids

Background: End-of-life decisions for companion animals can be stressful for veterinarians and owners, and when delayed result in poor animal welfare. Delayed euthanasia has been identified as a particularly prominent issue for horses. This scoping review aimed to identify the available literature on veterinary decision-making models, which can support end-of-life planning. Methods: A protocol was preregistered, and a structured literature search was performed on six electronic databases. Publications were reviewed against specifically developed eligibility criteria. Data from original studies and narrative-type reviews were extracted separately, and the components of each model were charted. Results: A total of 2211 publications were identified, 23 met the inclusion criteria and were included in the final review. Eight were original research studies and 15 were narrative reviews or similar. Publications were not indexed uniformly, increasing the difficulty of discovering relevant sources. The end-of-life decision-making process comprised three stages: (1) making the decision, (2) enacting the decision and (3) aftercare. Twenty key components of decision-making models were identified, although no publication reflected all of these. Conclusions: A lack of original research studies and equine-specific publications was identified. Shared decision-making models for euthanasia in veterinary practice should include all three stages and consider species-specific issues

Erratum:Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome (Future Cardiology (2014) 10:6 (693-698))

Following publication of the Clinical Trial Protocol by Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus McKiddie, Chim Lang, Dana Dawson and Michael Frenneaux, titled ‘Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome’, which appeared in the December 2014 issue of Future Cardiology (Future Oncol. 10[6], 693–698 [2014]), it has been brought to our attention that the author names were presented incorrectly as:Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus Mckiddie, Peter Nightingale, Chim Lang, Dana Dawson and Michael Frenneaux.The correct presentation should be:Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus Mckiddie, Chim Lang, Dana Dawson and Michael Frenneaux.The authors and editors of Future Cardiology would like to sincerely apologize for any inconvenience or confusion this may have caused our readers.<br/

Erratum:Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome (Future Cardiology (2014) 10:6 (693-698))

Following publication of the Clinical Trial Protocol by Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus McKiddie, Chim Lang, Dana Dawson and Michael Frenneaux, titled ‘Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome’, which appeared in the December 2014 issue of Future Cardiology (Future Oncol. 10[6], 693–698 [2014]), it has been brought to our attention that the author names were presented incorrectly as:Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus Mckiddie, Peter Nightingale, Chim Lang, Dana Dawson and Michael Frenneaux.The correct presentation should be:Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus Mckiddie, Chim Lang, Dana Dawson and Michael Frenneaux.The authors and editors of Future Cardiology would like to sincerely apologize for any inconvenience or confusion this may have caused our readers.<br/

Diastolic Ventricular Interaction in Heart Failure With Preserved Ejection Fraction

Background Exercise‐induced pulmonary hypertension is common in heart failure with preserved ejection fraction (HFpEF). We hypothesized that this could result in pericardial constraint and diastolic ventricular interaction in some patients during exercise. Methods and Results Contrast stress echocardiography was performed in 30 HFpEF patients, 17 hypertensive controls, and 17 normotensive controls (healthy). Cardiac volumes, and normalized radius of curvature (NRC) of the interventricular septum at end‐diastole and end‐systole, were measured at rest and peak‐exercise, and compared between the groups. The septum was circular at rest in all 3 groups at end‐diastole. At peak‐exercise, end‐systolic NRC increased to 1.47±0.05 (P<0.001) in HFpEF patients, confirming development of pulmonary hypertension. End‐diastolic NRC also increased to 1.54±0.07 (P<0.001) in HFpEF patients, indicating septal flattening, and this correlated significantly with end‐systolic NRC (ρ=0.51, P=0.007). In hypertensive controls and healthy controls, peak‐exercise end‐systolic NRC increased, but this was significantly less than observed in HFpEF patients (HFpEF, P=0.02 versus hypertensive controls; P<0.001 versus healthy). There were also small, non‐significant increases in end‐diastolic NRC in both groups (hypertensive controls, +0.17±0.05, P=0.38; healthy, +0.06±0.03, P=0.93). In HFpEF patients, peak‐exercise end‐diastolic NRC also negatively correlated (r=−0.40, P<0.05) with the change in left ventricular end‐diastolic volume with exercise (ie, the Frank‐Starling mechanism), and a trend was noted towards a negative correlation with change in stroke volume (r=−0.36, P=0.08). Conclusions Exercise pulmonary hypertension causes substantial diastolic ventricular interaction on exercise in some patients with HFpEF, and this restriction to left ventricular filling by the right ventricle exacerbates the pre‐existing impaired Frank‐Starling response in these patients

Comparison of intramyocellular lipid metabolism in patients with diabetes and male athletes

Contributions D.D., A.H., S.G., S.P. and M.D. conceived the study and together with L.v.L., G.L., F.T. obtained the grant funding. AM executed the patient screening, recruitment, intervention planning, carried out all study investigations under respective specialist supervision (A.H./D.C./D.D. for magnetic resonance spectroscopy, F.T./G.L./D.D. for stable isotope investigation, S.G. for exercise intervention, S.P. for clinical supervision/management of diabetes as required, M.D. for all molecular laboratory analyses, A.M. analysed all data and performed statistical analysis under the supervision of G.H. L.v.L. provided expert advice in athletic physiology. Lipidomic analyses were carried out in P.W. laboratory. Blood/skeletal muscle enrichment analyses were carried out in B.F./F.T.-G.L. laboratories respectively, with practical input from R.G. A.R. and L.C. contributed as overall help to deliver study assessments in a technical role. M.K.H. analysed the food diaries. D.E.N. contributed to manuscript writing. D.D. and M.D. were the PhD supervisors for A.M. whose PhD thesis was based on this work. All authors contributed their respective specialist sections in drafting the manuscript.Peer reviewe

Comprehensive Echocardiographic and Cardiovascular Magnetic Resonance Evaluation Differentiates Between Patients with Heart Failure with Preserved Ejection Fraction, Hypertensive Patients and Healthy Controls

Objectives: The aim of this study was to investigate the utility of a comprehensive imaging protocol including echocardiography and cardiac magnetic resonance in the diagnosis and differentiation of hypertensive heart disease and heart failure with preserved ejection fraction (HFpEF). Background: Hypertension is present in up to 90% of patients with HFpEF and is a major etiological component. Despite current recommendations and diagnostic criteria for HFpEF, no noninvasive imaging technique has as yet shown the ability to identify any structural differences between patients with hypertensive heart disease and HFpEF. Methods: We conducted a prospective cross-sectional study of 112 well-characterized patients (62 with HFpEF, 22 with hypertension, and 28 healthy control subjects). All patients underwent cardiopulmonary exercise and biomarker testing and an imaging protocol including echocardiography with speckle-tracking analysis and cardiac magnetic resonance including T1 mapping pre- and post-contrast. Results: Echocardiographic global longitudinal strain (GLS) and extracellular volume (ECV) measured by cardiac magnetic resonance were the only variables able to independently stratify among the 3 groups of patients. ECV was the best technique for differentiation between hypertensive heart disease and HFpEF (ECV area under the curve: 0.88; GLS area under the curve: 0.78; p &#60; 0.001 for both). Using ECV, an optimal cutoff of 31.2% gave 100% sensitivity and 75% specificity. ECV was significantly higher and GLS was significantly reduced in subjects with reduced exercise capacity (lower peak oxygen consumption and higher minute ventilation–carbon dioxide production) (p &#60; 0.001 for both ECV and GLS). Conclusions: Both GLS and ECV are able to independently discriminate between hypertensive heart disease and HFpEF and identify patients with prognostically significant functional limitation. ECV is the best diagnostic discriminatory marker of HFpEF and could be used as a surrogate endpoint for therapeutic studies