84 research outputs found
Respiratory patient experience of measures to reduce risk of COVID-19: findings from a descriptive cross-sectional UK wide survey
Objectives: To assess the experience of people with long-term respiratory conditions regarding the impact of measures to reduce risk of COVID-19. Design: Analysis of data (n=9,515) from the Asthma UK and British Lung Foundation partnership COVID-19 survey collected online between 1st and 8th of April 2020. Setting: Community Participants: 9,515 people with self-reported long term respiratory conditions. 81% female, age ranges from <17 years to 80 and above, from all nations of the UK. Long term respiratory conditions reported included asthma (83%), Chronic Obstructive Pulmonary Disease (COPD) (10%), bronchiectasis (4%), Interstitial Lung Disease (ILD) (2%), and ‘other’ (<1%) (e.g. lung cancer and pulmonary endometriosis). Outcome measures: Study responses related to impacts on key elements of health care, as well as practical, psychological and social consequences related to the COVID-19 pandemic and social distancing measures. Results: 45% reported disruptions to care, including cancellations of appointments, investigations, pulmonary rehabilitation, treatment, and monitoring. Other practical impacts such as difficulty accessing healthcare services for other issues, and getting basic necessities such as food, were also common. 36% did not use online prescriptions and 54% had not accessed online inhaler technique videos. Psycho-social impacts including anxiety, loneliness and concerns about personal health and family were prevalent. 81% reported engaging in physical activity. Among the 11% who were smokers, 48% reported they were planning to quit smoking because of COVID-19. Conclusions: COVID-19 and related social distancing measures are having profound impacts on people with chronic respiratory conditions. Urgent adaptation and signposting of services is required to mitigate the negative health consequences of the COVID-19 response for this group
Acceptability of hygiene, face covering and social distancing interventions to prevent exacerbations in people living with airways diseases
Interventions to prevent the spread of SARS-CoV-2 have been associated with substantial reductions in exacerbations of airways diseases, likely through reduced transmission of other respiratory viruses. We surveyed 4442 people with airways disease (asthma=3627, bronchiectasis=258, chronic obstructive pulmonary disease=557) to gauge attitudes and intentions towards continuing such measures after the COVID-19 pandemic. 47% intended to continue wearing a face mask in indoor public spaces, and 61% thought everyone should be required to do so during the ‘influenza season. Women, those with bronchiectasis, and older people were generally more cautious. Respiratory virus infection control measures should be considered in clinical guidelines and public health recommendations
The General Practice Care of People With Intellectual Disability: Barriers and Solutions
A questionnaire exploring general practitioners' (GPs) perceptions of the barriers and solutions to providing health care to people with intellectual disability was sent to 912 randomly selected GPs throughout Australia. a response rate of 58% was obtained. Results indicated that numerous barriers compromised the quality of health care able to be provided to people with intellectual disability. communications difficulties with patients and other health professionals, and problems in obtaining patient histories stood out as the two most significant barriers. A range of other barriers were identified, including GPs' lack of training and experience, patients' poor compliance with management plans, consultation time constraints, difficulties in problem determination, examination difficulties, poor continuity of care, and GPs' inadequate knowledge of the services and resources available. General practitioners also suggested numerous solutions to these barriers, and emphasized the need for increased opportunities for education and training in intellectual disability. The GPs showed an overwhelming interest to be involved in further education. Other major solutions included increasing consultation duration or frequency, proactively involving families and carers in patients' ongoing health care, and increasing remuneration
Associations between body mass index, weight control concerns and behaviors, and eating disorder symptoms among non-clinical Chinese adolescents
<p>Abstract</p> <p>Background</p> <p>Previous research with adolescents has shown associations of body weight, weight control concerns and behaviors with eating disorder symptoms, but it is unclear whether these associations are direct or whether a mediating effect exists. This study was conducted to investigate the prevalence of overweight and obesity, weight control concerns and behaviors, and eating disorder symptoms and to examine the mediating function of weight control concerns and behaviors on the relationship between body mass index (BMI) and eating disorder symptoms among non-clinical adolescents in China.</p> <p>Methods</p> <p>A cross-sectional survey among 2019 adolescent girls and 1525 adolescent boys in the 7th, 8th, 10th and 11th grades from seven cities in China was conducted. Information on weight control concerns and behaviors, and eating disorder symptoms (Eating Disorder Inventory-3) were collected from the adolescents using a self-administrated questionnaire.</p> <p>Results</p> <p>Weight control concerns and behaviors, and eating disorder symptoms were prevalent among the study population. A high proportion of adolescents scored at or above the threshold on the eating disorder inventory (EDI) subscale such as bulimia, interoceptive deficits, perfectionism, and maturity fears, which indicated eating disorder symptoms. High BMI was significantly associated with high score of drive for thinness, body dissatisfaction, bulimia, low self-esteem, interceptive deficits and maturity fears, so do perceived body weight status. Almost all weight control concerns and behaviors we investigated were significantly associated with high EDI subscale scores. When weight control concerns were added to the model, as shown in the model, the association between BMI and tendency of drive to thinness and bulimia was attenuated but still kept significant. The association between BMI and body dissatisfaction were no further significant. The association of BMI and drive for thinness, body dissatisfaction and bulimia was considerably weaker than when weight control behaviors were not included.</p> <p>Conclusions</p> <p>Weight control concerns and behaviors may be mediators of the association between BMI and eating disorder symptoms. Interpretation of these weight control problems is crucial to develop culturally appropriate educational and intervention programs for adolescents.</p
Provenance of Cretaceous through Eocene strata of the Four Corners region: Insights from detrital zircons in the San Juan Basin, New Mexico and Colorado
Cretaceous through Eocene strata of the Four Corners region provide an excellent record of changes in sediment provenance from Sevier thin-skinned thrusting through the formation of Laramide block uplifts and intra-foreland basins. During the ca. 125–50 Ma timespan, the San Juan Basin was flanked by the Sevier thrust belt to the west, the Mogollon highlands rift shoulder to the southwest, and was influenced by (ca. 75–50 Ma) Laramide tectonism, ultimately preserving a >6000 ft (>2000 m) sequence of continental, marginal-marine, and offshore marine sediments. In order to decipher the influences of these tectonic features on sediment delivery to the area, we evaluated 3228 U-Pb laser analyses from 32 detrital-zircon samples from across the entire San Juan Basin, of which 1520 analyses from 16 samples are newly reported herein. The detrital-zircon results indicate four stratigraphic intervals with internally consistent age peaks: (1) Lower Cretaceous Burro Canyon Formation, (2) Turonian (93.9–89.8 Ma) Gallup Sandstone through Campanian (83.6–72.1 Ma) Lewis Shale, (3) Campanian Pictured Cliffs Sandstone through Campanian Fruitland Formation, and (4) Campanian Kirtland Sandstone through Lower Eocene (56.0–47.8 Ma) San Jose Formation. Statistical analysis of the detrital-zircon results, in conjunction with paleocurrent data, reveals three distinct changes in sediment provenance. The first transition, between the Burro Canyon Formation and the Gallup Sandstone, reflects a change from predominantly reworked sediment from the Sevier thrust front, including uplifted Paleozoic sediments and Mesozoic eolian sandstones, to a mixed signature indicating both Sevier and Mogollon derivation. Deposition of the Pictured Cliffs Sandstone at ca. 75 Ma marks the beginning of the second transition and is indicated by the spate of near-depositional-age zircons, likely derived from the Laramide porphyry copper province of southern Arizona and southwestern New Mexico. Paleoflow indicators suggest the third change in provenance was complete by 65 Ma as recorded by the deposition of the Paleocene Ojo Alamo Sandstone. However, our new U-Pb detrital-zircon results indicate this transition initiated ∼8 m.y. earlier during deposition of the Campanian Kirtland Formation beginning ca. 73 Ma. This final change in provenance is interpreted to reflect the unroofing of surrounding Laramide basement blocks and a switch to local derivation. At this time, sediment entering the San Juan Basin was largely being generated from the nearby San Juan Mountains to the north-northwest, including uplift associated with early phases of Colorado mineral belt magmatism. Thus, the detrital-zircon spectra in the San Juan Basin document the transition from initial reworking of the Paleozoic and Mesozoic cratonal blanket to unroofing of distant basement-cored uplifts and Laramide plutonic rocks, then to more local Laramide uplifts.National Science Foundation (NSF grant EAR-1649254
Smoking and socio-economic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey
Background: Understanding the factors driving acute exacerbations of COPD is key to reducing their impact on human health and wellbeing. Methods: 5997 patients, mean 66 years, 64% female, completed an online survey between December 2020 and May 2021 about living with COPD developed by the charity Asthma+Lung UK. Results: The 3731(62.2%) survey participants reporting frequent(>2/year) exacerbations were more likely to smoke (AOR 1.70, 95%CI 1.470-1.98), have lower annual household income (<£20,000, (AOR: 1.72, 1.36-2.17), live in a cold and damp home (AOR: 1.78, 1.50-2.11), and report previous occupational exposure to dust, fumes, and chemicals. Smokers were more likely to report attending hospital to manage their most recent AECOPD compared to ex-smokers (AOR: 1.25, 95% CI 0.99- 1.59)
The Rough Road and the Smooth Road: Comparing Access to Social Care for Older People via Area Teams and GP Surgeries
Stochastic Bayesian inversion of borehole self-potential measurements
International audienceWe propose a mechanistic model to compute and to invert self-potential log data in sedimentary basins and for near-surface geophysical applications. The framework of our analysis is founded in a unified electrical conductivity and self-potential petrophysical model. This model is based on an explicit dependence of these properties on porosity, water saturation, temperature, brine salinity, cementation and saturation (Archie) exponents and the volumetric charge density per unit pore volume associated with the clay fraction. This model is consistent with empirical laws widely used to interpret self-potential logs according to the two limiting cases corresponding to a clean sand and a pure shale. We present a finite element calculation of the self-potential signal produced by sand reservoirs interstratified with shale layers. For layered strata normal to the well, we demonstrate that the 3-D Poisson equation governing the occurrence of self-potentials in a borehole can be simplified to a 2-D axisymmetric partial differential equation solved at each depth providing a common self-potential reference can be defined between these different depths. This simplification is very accurate as long as the vertical salinity gradients are not too strong over distances corresponding to the borehole diameter. The inversion of borehole data (self-potential, resistivity and density well logs, incorporating information derived from neutron porosity and gamma-ray log data) is performed with the Adaptive Metropolis Algorithm (AMA). We start by formulating an approximate analytical solution for the six model parameters (water saturation, porosity, the two Archie's exponents, the pore water conductivity and the volumetric charge density of the diffuse layer). This solution is used for the AMA algorithm to converge in less than 60 iterations at each depth for the real case study. The posterior probability distributions are computed using 50-60 additional realizations. Our approach is applied to a case study concerning a small sedimentary sequence in the Piceance Basin, Colorado, in a series of tight gas reservoirs
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