Public health responses to influenza in care homes: a questionnaire-based study of local Health Protection Units.

BACKGROUND: Influenza virus infection poses a major threat to the elderly people in residential care. We sought to describe the extent to which local public health services in England were positioned to detect and respond effectively to influenza-like illness (ILI) in nursing homes. METHODS: A questionnaire-based survey was conducted in all 34 Health Protection Units (HPUs) regarding the 2004-05 influenza season. RESULTS: Of the 20 responses, half reported 24 outbreaks of ILI in care homes. The mean resident population attack rate was 41% (range 15-79) with 31 deaths. Staff ILI occurred in 23 of 24 outbreaks. Seven of 20 HPUs stated that a local policy for the management of ILI in nursing homes was in place, with only four specifying the use of neuraminidase inhibitors (NI) for treatment of cases and prophylaxis of residents. In the outbreaks reported, NIs were used for treatment and prophylaxis, respectively, in only 46 and 54% of instances. CONCLUSIONS: Given the availability of effective interventions for treatment and prophylaxis, there is potential to prevent substantial morbidity and mortality from influenza in at-risk populations. This study suggests that challenges remain in the effective response to influenza outbreaks in care homes and that there are wide variations in practice at local level

Employees’ support strategies for mental wellbeing during and beyond the COVID-19 pandemic: Recommendations for employers in the UK workforce

Throughout the COVID-19 pandemic, and beyond for many businesses, employees have had to adapt to new ways of working due to disruptions in traditional practices. It is therefore crucial to understand the new challenges that employees are facing when it comes to taking care of their mental wellbeing at work. To that end, we distributed a survey to full-time UK employees (N = 451) to explore how supported they felt throughout the pandemic, and to identify whether there are any additional types of support they would like to receive. We also compared employees’ intentions to seek help before versus during the COVID-19 pandemic, and assessed their current attitudes toward mental health. Based on direct employee feedback, our results show remote workers felt more supported throughout the pandemic compared to hybrid workers. We also found that employees who had previously experienced an episode of anxiety or depression were significantly more likely to want extra support at work compared to those who had not. Furthermore, employees were significantly more likely to seek help for their mental health during the pandemic compared to before. Interestingly, the largest increase in intentions to seek help during the pandemic compared to before was with digital health solutions. Finally, we found that the strategies managers have adopted to better support their employees, an employee’s mental health history, and their attitude to mental health all contributed to significantly increasing the likelihood that an employee would disclose a mental health concern to their line manager. We provide recommendations that encourage organisations to make changes to better support their employees, and we highlight the importance of mental health awareness training for both managers and employees. This work is of particular interest to organisations who are looking to tailor their current employee wellbeing offer to a post-pandemic world

Assessing recreational fisheries in an emerging economy: Knowledge,perceptions and attitudes of catch-and-release anglers in India

ABSTRACT: Across the globe, catch-and-release (C&R) angling represents a leisure activity indulged by millions. The practice of C&R is commonly advocated by conservation managers because of its potential to protect local fish populations from a range of anthropogenic threats, including over-fishing. In India, C&R angling in fresh waters has a history dating back to colonial times. Despite this, little is known about the current state of the sector. To address this, an online web-based survey was conducted to target C&R anglers who fish in Indian rivers to assess their knowledge, attitudes and perceptions relating to the status of India's freshwater C&R fisheries. From a total of 148 responses, factors such as angling quality (score of 4.6/5.0); aesthetics of surroundings (4.6/5.0), presence of other wildlife (4.4/5.0), fishery management practices (4.6/5.0) and socioeconomic benefits (4.4/5.0) were evaluated. Over 65% (n = 148) of the anglers reported an observed decrease in the quality of fishing (e.g. a reduction in the size and/or numbers of fish available for capture). Respondents also considered deforestation (score of 4.2/5.0), water abstraction (4.4/5.0), pollution (4.4/5.0), hydropower projects (4.2/5.0) and destructive fishing techniques (4.7/5.0) as factors which threaten both the habitat and species they target. C&R practitioners were largely united regarding the benefits and willingness to contribute both their time and financial input to support conservation initiatives (score of 4.7/5.0). The current study provides the first overview of the status of C&R angling in India and explores challenges, opportunities, and priorities for future resource management

Predictors of recurrence, early treatment failure and death from Staphylococcus aureus bacteraemia: observational analyses within the ARREST trial

Adjunctive rifampicin did not reduce failure/recurrence/death as a composite endpoint in the ARREST trial of Staphylococcus aureus bacteraemia, but did reduce recurrences. We investigated clinically-defined 14-day treatment failure, and recurrence and S. aureus-attributed/unattributed mortality by 12-weeks to further define their predictor

A physiological perspective on fisheries-induced evolution

There is increasing evidence that intense fishing pressure is not only depleting fish stocks but also causing evolutionary changes to fish populations. In particular, body size and fecundity in wild fish populations may be altered in response to the high and often size-selective mortality exerted by fisheries. While these effects can have serious consequences for the viability of fish populations, there are also a range of traits not directly related to body size which could also affect susceptibility to capture by fishing gears – and therefore fisheries-induced evolution (FIE) – but which have to date been ignored. For example, overlooked within the context of FIE is the likelihood that variation in physiological traits could make some individuals within species more vulnerable to capture. Specifically, traits related to energy balance (e.g. metabolic rate), swimming performance (e.g. aerobic scope), neuroendocrinology (e.g. stress responsiveness), and sensory physiology (e.g., visual acuity) are especially likely to influence vulnerability to capture through a variety of mechanisms. Selection on these traits could produce major shifts in the physiological traits within populations in response to fishing pressure that are yet to be considered but which could influence population resource requirements, resilience, species’ distributions, and responses to environmental change

It’s the talk: A study of involvement initiatives in secure mental health settings

Background: A study of involvement initiatives within secure mental health services across one UK region, where these have been organised to reflect alliances between staff and service users. There is little previous relevant international research, but constraints upon effective involvement have been noted. Objective: To explore and evaluate involvement initiatives in secure mental health settings. Design: A case study design with thematic analysis of qualitative interviews and focus groups. Setting and participants: Data collection was carried out between October 2011 and February 2012 with 139 staff and service users drawn from a variety of secure mental health settings. Findings: Our analysis offers four broad themes, titled: safety and security first?; bringing it all back home; it picks you up; it’s the talk. The quality of dialogue between staff and services users was deemed of prime importance. Features of secure environments could constrain communication, and the best examples of empowerment took place in non-secure settings. Discussion: Key aspects of communication and setting sustain involvement. These features are discussed with reference to Jurgen Habermas's work on communicative action and deliberative democracy. Conclusions: Involvement initiatives with service users resident in secure hospitals can be organized to good effect and the active role of commissioners is crucial. Positive outcomes are optimized when care is taken over the social space where involvement takes place and the process of involvement is appreciated by participants. Concerns over risk management are influential in staff support. This is germane to innovative thinking about practice and policy in this field

Partner (dis)agreement on moving desires and the subsequent moving behaviour of couples

Residential mobility decisions are known to be made at the household level. However, most empirical analyses of residential mobility relate moving behaviour to the housing and neighbourhood satisfaction and pre-move thoughts of individuals. If partners in a couple do not share evaluations of dwelling or neighbourhood quality or do not agree on whether moving is (un)desirable, ignoring these disagreements will lead to an inaccurate assessment of the strength of the links between moving desires and actual moves. This study is one of the first to investigate disagreements in moving desires between partners and the subsequent consequences of such disagreements for moving behaviour. Drawing on British Household Panel Survey (BHPS) data, we find that disagreement about the desirability of moving is most likely where partners also disagree about the quality of their dwelling or neighbourhood. Panel logistic regression models show that the moving desires of both partners interact to affect the moving behaviour of couples. Only 7.6% of couples move if only the man desires to move, whereas 20.1% of shared moving desires lead to a subsequent move.This is the pre-peer reviewed version of the following article: Coulter, R., van Ham, M. and Feijten, P. 2012. Partner (dis)agreement on moving desires and the subsequent moving behaviour of couples. Population, Space and Place 18(1), pp. 16-30, which has been published in final form at http://dx.doi.org/10.1002/psp.700

Interventions for promoting smoking cessation during pregnancy.

BACKGROUND: Smoking remains one of the few potentially preventable factors associated with low birthweight, preterm birth and perinatal death. OBJECTIVES: To assess the effects of smoking cessation programs implemented during pregnancy on the health of the fetus, infant, mother, and family. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Tobacco Addiction Group trials register (July 2003), MEDLINE (January 2002 to July 2003), EMBASE (January 2002 to July 2003), PsychLIT (January 2002 to July 2003), CINAHL (January 2002 to July 2003), and AUSTHEALTH (January 2002 to 2003). We contacted trial authors to locate additional unpublished data. We handsearched references of identified trials and recent obstetric journals. SELECTION CRITERIA: Randomised and quasi-randomised trials of smoking cessation programs implemented during pregnancy. DATA COLLECTION AND ANALYSIS: Four reviewers assessed trial quality and extracted data independently. MAIN RESULTS: This review included 64 trials. Fifty-one randomised controlled trials (20,931 women) and six cluster-randomised trials (over 7500 women) provided data on smoking cessation and/or perinatal outcomes. Despite substantial variation in the intensity of the intervention and the extent of reminders and reinforcement through pregnancy, there was an increase in the median intensity of both 'usual care' and interventions over time. There was a significant reduction in smoking in the intervention groups of the 48 trials included: (relative risk (RR) 0.94, 95% confidence interval (CI) 0.93 to 0.95), an absolute difference of six in 100 women continuing to smoke. The 36 trials with validated smoking cessation had a similar reduction (RR 0.94, 95% CI 0.92 to 0.95). Smoking cessation interventions reduced low birthweight (RR 0.81, 95% CI 0.70 to 0.94) and preterm birth (RR 0.84, 95% CI 0.72 to 0.98), and there was a 33 g (95% CI 11 g to 55 g) increase in mean birthweight. There were no statistically significant differences in very low birthweight, stillbirths, perinatal or neonatal mortality but these analyses had very limited power. One intervention strategy, rewards plus social support (two trials), resulted in a significantly greater smoking reduction than other strategies (RR 0.77, 95% CI 0.72 to 0.82). Five trials of smoking relapse prevention (over 800 women) showed no statistically significant reduction in relapse. REVIEWERS' CONCLUSIONS: Smoking cessation programs in pregnancy reduce the proportion of women who continue to smoke, and reduce low birthweight and preterm birth. The pooled trials have inadequate power to detect reductions in perinatal mortality or very low birthweight

Recurrent rearrangements of human amylase genes create multiple independent CNV series

The human amylase gene cluster includes the human salivary (AMY1) and pancreatic amylase genes (AMY2A and AMY2B), and is a highly variable and dynamic region of the genome. Copy number variation (CNV) of AMY1 has been implicated in human dietary adaptation, and in population association with obesity, but neither of these findings has been independently replicated. Despite these functional implications, the structural genomic basis of CNV has only been defined in detail very recently. In this work, we use high-resolution analysis of copy number, and analysis of segregation in trios, to define new, independent allelic series of amylase CNVs in sub-Saharan Africans, including a series of higher-order expansions of a unit consisting of one copy each of AMY1, AMY2A, and AMY2B. We use fiber-FISH (fluorescence in situ hybridization) to define unexpected complexity in the accompanying rearrangements. These findings demonstrate recurrent involvement of the amylase gene region in genomic instability, involving at least five independent rearrangements of the pancreatic amylase genes (AMY2A and AMY2B). Structural features shared by fundamentally distinct lineages strongly suggest that the common ancestral state for the human amylase cluster contained more than one, and probably three, copies of AMY1