54 research outputs found
Time lost due to an attack: a novel patient-reported outcome measure for acute migraine treatments
Objective We propose a new outcome measure to assess the efficacy of migraine treatments translating the approach of the Global Burden of Disease studies from a societal to an individual level: Instead of calculating "years lived with disability", we suggest estimating "time lost due to an attack".MethodsTime lost due to an attack is calculated by multiplying the duration and the degree of impaired functioning during an attack.ResultsTime lost due to an attack, different from other outcome measures, does not just focus on the short-term analgesic effects of treatments, but rather on the improvement of all migraine symptoms and restoration of functioning, also considering therapy-related impairment. Importantly, time lost due to an attack measures the entire time patients are not functioning normally, from onset to complete resolution.ConclusionsTime lost due to an attack represents a new paradigm to assess migraine burden in single patients for a patient-centered evaluation of both acute and prophylactic treatments.Paroxysmal Cerebral Disorder
Infection control and the prevalence, management and outcomes of SARS-CoV-2 infections in mental health wards in London, UK: lessons learned from wave 1 to wave 2.
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has high morbidity and mortality in older adults and people with dementia. Infection control and prevention measures potentially reduce transmission within hospitals. AIMS: We aimed to replicate our earlier study of London mental health in-patients to examine changes in clinical guidance and practice and associated COVID-19 prevalence and outcomes between COVID-19 waves 1 and 2 (1 March to 30 April 2020 and 14 December 2020 to 15 February 2021). METHOD: We collected the 2 month period prevalence of wave 2 of COVID-19 in older (≥65 years) in-patients and those with dementia, as well as patients' characteristics, management and outcomes, including vaccinations. We compared these results with those of our wave 1 study. RESULTS: Sites reported that routine testing and personal protective equipment were available, and routine patient isolation on admission occurred throughout wave 2. COVID-19 infection occurred in 91/358 (25%; 95% CI 21-30%) v. 131/344, (38%; 95% CI 33-43%) P < 0.001 in wave 1. Hospitals identified more asymptomatic carriers (26/91; 29% v. 16/130; 12%) and fewer deaths (12/91; 13% v. 19/131; 15%; odds ratio = 0.92; 0.37-1.81) compared with wave 1. The patient vaccination uptake rate was 49/58 (85%). CONCLUSIONS: Patients in psychiatric in-patient settings, mostly admitted without known SARS-CoV-2 infection, had a high risk of infection compared with people in the community but lower than that during wave 1. Availability of infection control measures in line with a policy of parity of esteem between mental and physical health appears to have lowered within-hospital COVID-19 infections and deaths. Cautious management of vulnerable patient groups including mental health patients may reduce the future impact of COVID-19
General Principles for the Welfare of Animals in Production Systems: The Underlying Science and Its Application
In 2012, the World Organisation for Animal Health adopted 10 ‘General Principles for the Welfare of Animals in Livestock Production Systems’ to guide the development of animal welfare standards. The General Principles draw on half a century of scientific research relevant to animal welfare: (1) how genetic selection affects animal health, behaviour and temperament; (2) how the environment influences injuries and the transmission of diseases and parasites; (3) how the environment affects resting, movement and the performance of natural behaviour; (4) the management of groups to minimize conflict and allow positive social contact; (5) the effects of air quality, temperature and humidity on animal health and comfort; (6) ensuring access to feed and water suited to the animals’ needs and adaptations; (7) prevention and control of diseases and parasites, with humane euthanasia if treatment is not feasible or recovery is unlikely; (8) prevention and management of pain; (9) creation of positive human–animal relationships; and (10) ensuring adequate skill and knowledge among animal handlers. Research directed at animal welfare, drawing on animal behaviour, stress physiology, veterinary epidemiology and other fields, complements more established fields of animal and veterinary science and helps to create a more comprehensive scientific basis for animal care and management
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Boredom-like states in mink and their behavioural correlates: a replicate study
Scientists and laypeople have long expressed concern that animals in non-enriched, unchanging environments might experience boredom. However, this had attracted little empirical study: the state is difficult to assess without verbal self-reports, and spontaneous behavioural signs of boredom can vary in humans, making it hard to identify signs likely to be valid in other species. We operationally define boredom as a negative state that causes an increased, generalised interest in diverse stimuli. Previously, we demonstrated that this state existed in mink housed in non-enriched cages, compared to those in preferred, stress-reducing enriched enclosures; and that this heightened interest in stimuli positively correlated with time spent lying still but awake, while negatively correlating with locomotor stereotypic behaviour. However, these results needed replication. The current study tested for the same effects, in a new cohort of 20 male mink, by presenting 11 stimuli ranging from those predicted to typically be aversive (e.g. predator cues) to those predicted to be rewarding (e.g. food rewards; moving objects to chase). Where housing treatments differed, non-enriched mink were again more interested in the stimuli presented, spending longer oriented towards and in contact with them (e.g. for aversive stimuli: F1,9=6.27, p=0.034 and F1,9=8.24, p=0.019, respectively). Lying still but awake again correlated with interest in the stimuli (shorter latencies to contact rewarding stimuli: F1,17=3.70, p=0.036; in enriched mink only, more time oriented to and in contact with all stimuli: F1,8=9.49, p=0.015 and F1,8=15.9, p=0.004). In contrast, the previous correlations with stereotypic behaviour were not replicated. We therefore conclude that mink housed in non-enriched cages likely experience boredom-like states, and that time spent lying still while awake could potentially be used as a cage-side indicator of these states. We also suggest how future researchers might address further fundamental and practical questions about animal boredom, in mink and other species
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