The impact of the economic downturn on health in Wales: a review and case study

The current economic downturn and the austerity measures currently being decided with regard to public spending are likely to impact on people’s lives in a number of different ways. The test of how well political administrations respond to such crises will be the extent to which the health and well being of its populations are protected. The lesson of previous downturns is that the social and associated health impacts can lag long after what can be a relatively short period of economic recession. These effects can also be uneven and affect particular groups in the population and people living in particular places more than others. However in order for Governments, local authorities and services to respond appropriately we need to learn from the past whilst acknowledging the unique character of this particular social and economic crisis. In South Wales people are still dealing with the emotional and physical wounds which are the legacy of rapid re‐industrialisation in the 1980s and we need to be prepared this time round. This is report comprises a literature review of what is known about the health impact of past recessions and their aftermaths, a qualitative case study of perceived current and potential health impacts on relevant statutory and voluntary services in two contrasting local authority areas, and a policy dialogue to discuss the findings with a small group of policy makers and service leads with national and local responsibilities. The report concludes with a number of broad recommendations to support and guide decisions at national and local government levels

Does gender matter? A cross-national investigation of primary class-room discipline.

© 2018 Informa UK Limited, trading as Taylor & Francis GroupFewer than 15% of primary school teachers in both Germany and the UK are male. With the on-going international debate about educational performance highlighting the widening gender achievement gap between girl and boy pupils, the demand for more male teachers has become prevalent in educational discourse. Concerns have frequently been raised about the underachievement of boys, with claims that the lack of male ‘role models’ in schools has an adverse effect on boys’ academic motivation and engagement. Although previous research has examined ‘teaching’ as institutional talk, men’s linguistic behaviour in the classroom remains largely ignored, especially in regard to enacting discipline. Using empirical spoken data collected from four primary school classrooms in both the UK and in Germany, this paper examines the linguistic discipline strategies of eight male and eight female teachers using Interactional Sociolinguistics to address the question, does teacher gender matter?Peer reviewedFinal Accepted Versio

Cellular and humoral immune responses and protection against schistosomes induced by a radiation-attenuated vaccine in chimpanzees

The radiation-attenuated Schistosoma mansoni vaccine is highly effective in rodents and primates but has never been tested in humans, primarily for safety reasons. To strengthen its status as a paradigm for a human recombinant antigen vaccine, we have undertaken a small-scale vaccination and challenge experiment in chimpanzees (Pan troglodytes). Immunological, clinical, and parasitological parameters were measured in three animals after multiple vaccinations, together with three controls, during the acute and chronic stages of challenge infection up to chemotherapeutic cure. Vaccination induced a strong in vitro proliferative response and early gamma interferon production, but type 2 cytokines were dominant by the time of challenge. The controls showed little response to challenge infection before the acute stage of the disease, initiated by egg deposition. In contrast, the responses of vaccinated animals were muted throughout the challenge period. Vaccination also induced parasite-specific immunoglobulin M (IgM) and IgG, which reached high levels at the time of challenge, while in control animals levels did not rise markedly before egg deposition. The protective effects of vaccination were manifested as an amelioration of acute disease and overall morbidity, revealed by differences in gamma-glutamyl transferase level, leukocytosis, eosinophilia, and hematocrit. Moreover, vaccinated chimpanzees had a 46% lower level of circulating cathodic antigen and a 38% reduction in fecal egg output, compared to controls, during the chronic phase of infection

Development of a Rapid Soil Water Content Detection Technique Using Active Infrared Thermal Methods for In-Field Applications

The aim of this study was to investigate the suitability of active infrared thermography and thermometry in combination with multivariate statistical partial least squares analysis as rapid soil water content detection techniques both in the laboratory and the field. Such techniques allow fast soil water content measurements helpful in both agricultural and environmental fields. These techniques, based on the theory of heat dissipation, were tested by directly measuring temperature dynamic variation of samples after heating. For the assessment of temperature dynamic variations data were collected during three intervals (3, 6 and 10 s). To account for the presence of specific heats differences between water and soil, the analyses were regulated using slopes to linearly describe their trends. For all analyses, the best model was achieved for a 10 s slope. Three different approaches were considered, two in the laboratory and one in the field. The first laboratory-based one was centred on active infrared thermography, considered measurement of temperature variation as independent variable and reported r = 0.74. The second laboratory–based one was focused on active infrared thermometry, added irradiation as independent variable and reported r = 0.76. The in-field experiment was performed by active infrared thermometry, heating bare soil by solar irradiance after exposure due to primary tillage. Some meteorological parameters were inserted as independent variables in the prediction model, which presented r = 0.61. In order to obtain more general and wide estimations in-field a Partial Least Squares Discriminant Analysis on three classes of percentage of soil water content was performed obtaining a high correct classification in the test (88.89%). The prediction error values were lower in the field with respect to laboratory analyses. Both techniques could be used in conjunction with a Geographic Information System for obtaining detailed information on soil heterogeneity

Assessment and Management of Anti-insulin Autoantibodies in Varying Presentations of Insulin Autoimmune Syndrome

Context: Insulin autoimmune syndrome (IAS), spontaneous hyperinsulinemic hypoglycemia due to insulin-binding autoantibodies, may be difficult to distinguish from tumoral or other forms of hyperinsulinemic hypoglycemia including surreptitious insulin administration. No standardized treatment regimen exists. Objectives: To evaluate an analytic approach to IAS and responses to different treatments. Design and Setting: Observational study in the UK Severe Insulin Resistance Service. Patients: 6 patients with hyperinsulinemic hypoglycemia and detectable circulating anti-insulin antibody (IA). Main outcome measures: Glycemia, plasma insulin and C-peptide concentrations by immunoassay or mass spectrometry (MS). Immunoreactive insulin was determined in the context of polyethylene glycol (PEG) precipitation and gel filtration chromatography (GFC). IA quantification using enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA), and IA were further characterized using radioligand binding studies. Results: All patients were diagnosed with IAS (5 IgG, 1 IgA) based on high insulin:C-peptide ratio, low insulin recovery after PEG precipitation, and GFC evidence of antibody-bound insulin. Neither ELISA nor RIA result proved diagnostic for every case. MS provided a more robust quantification of insulin in the context of IA. 1 patient was managed conservatively, 4 were treated with diazoxide without sustained benefit, and 4 were treated with immunosuppression with highly variable responses. IA affinity did not appear to influence presentation or prognosis. Conclusions: IAS should be considered in patients with hyperinsulinemic hypoglycemia and a high insulin:C-peptide ratio. Low insulin recovery on PEG precipitation supports the presence of insulin-binding antibodies, with GFC providing definitive confirmation. Immunomodulatory therapy should be customized according to individual needs and clinical response

CD4(+)CD25(+)FOXP3(+) Regulatory T Cells Suppress Anti-Tumor Immune Responses in Patients with Colorectal Cancer

BACKGROUND: A wealth of evidence obtained using mouse models indicates that CD4(+)CD25(+)FOXP3(+) regulatory T cells (Treg) maintain peripheral tolerance to self-antigens and also inhibit anti-tumor immune responses. To date there is limited information about CD4(+) T cell responses in patients with colorectal cancer (CRC). We set out to measure T cell responses to a tumor-associated antigen and examine whether Treg impinge on those anti-tumor immune responses in CRC patients. METHODOLOGY AND PRINCIPAL FINDINGS: Treg were identified and characterized as CD4(+)CD25(+)FOXP3(+) using flow cytometry. An increased frequency of Treg was demonstrated in both peripheral blood and mesenteric lymph nodes of patients with colorectal cancer (CRC) compared with either healthy controls or patients with inflammatory bowel disease (IBD). Depletion of Treg from peripheral blood mononuclear cells (PBMC) of CRC patients unmasked CD4(+) T cell responses, as observed by IFNγ release, to the tumor associated antigen 5T4, whereas no effect was observed in a healthy age-matched control group. CONCLUSIONS/SIGNIFICANCE: Collectively, these data demonstrate that Treg capable of inhibiting tumor associated antigen-specific immune responses are enriched in patients with CRC. These results support a rationale for manipulating Treg to enhance cancer immunotherapy

Nitrogen Concentration Estimation in Tomato Leaves by VIS-NIR Non-Destructive Spectroscopy

Nitrogen concentration in plants is normally determined by expensive and time consuming chemical analyses. As an alternative, chlorophyll meter readings and N-NO3 concentration determination in petiole sap were proposed, but these assays are not always satisfactory. Spectral reflectance values of tomato leaves obtained by visible-near infrared spectrophotometry are reported to be a powerful tool for the diagnosis of plant nutritional status. The aim of the study was to evaluate the possibility and the accuracy of the estimation of tomato leaf nitrogen concentration performed through a rapid, portable and non-destructive system, in comparison with chemical standard analyses, chlorophyll meter readings and N-NO3 concentration in petiole sap. Mean reflectance leaf values were compared to each reference chemical value by partial least squares chemometric multivariate methods. The correlation between predicted values from spectral reflectance analysis and the observed chemical values showed in the independent test highly significant correlation coefficient (r = 0.94). The utilization of the proposed system, increasing efficiency, allows better knowledge of nutritional status of tomato plants, with more detailed and sharp information and on wider areas. More detailed information both in space and time is an essential tool to increase and stabilize crop quality levels and to optimize the nutrient use efficiency

Cohort profile: The UK COVID-19 Public Experiences (COPE) prospective longitudinal mixed-methods study of health and well-being during the SARSCoV2 coronavirus pandemic

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic

A Perspective on the Use of NB-UVB Phototherapy vs. PUVA Photochemotherapy

Narrowband UVB (NB-UVB) phototherapy and psoralen-UVA (PUVA) photochemotherapy are widely used phototherapeutic modalities for a range of skin diseases. The main indication for NB-UVB and PUVA therapies is psoriasis, and other key diagnoses include atopic eczema, vitiligo, cutaneous T-cell lymphoma (CTCL), and the photodermatoses. The decision on choice of phototherapy is important and NB-UVB is usually the primary choice. NB-UVB phototherapy is a safe and effective therapy which is usually considered when topical agents have failed. PUVA requires prior psoralen sensitization but remains a highly effective mainstay therapy, often used when NB-UVB fails, there is rapid relapse following NB-UVB or in specific indications, such as pustular or erythrodermic psoriasis. This review will provide a perspective on the main indications for use of NB-UVB and PUVA therapies and provide comparative information on these important dermatological treatments