An aid to the development of Botswana's resources

There are no author-identified significant results in this report

An aid to the development of Botswana's resources

There are no author-identified significant results in this report

An aid to the development of Botswana's resources

There are no author-identified significant results in this report

Does ‘playtime’ reduce stimulus-seeking and other boredom-like behaviour in laboratory ferrets?

Much environmental enrichment for laboratory animals is intended to enhance animal welfare and normalcy by providing stimulation to reduce 'boredom'. Behavioural manifestations of boredom include restless sensation-seeking behaviours combined with indicators of sub-optimal arousal. Here, we explored whether these signs could be reduced by extra daily play opportunity in laboratory ferrets (Mustela putorius furo). Specifically, we hypothesised that playtime would reduce restlessness, aggression, sensation-seeking and awake drowsiness, even 24 h later in the home-cage. Female ferrets (n = 14) were group-housed in enriched multi-level cages. Playtime involved exploring a room containing a ball pool, paper bags, balls containing bells, and a familiar interactive human for 1h. This was repeated on three consecutive mornings, and on the fourth, home-cage behaviour was compared between ferrets which had experienced the playtime treatment versus control cage-mates which had not. Their investigation of stimuli (positive=mouse odour or ball; ambiguous = empty bottle or tea-strainer; and negative = peppermint or bitter apple odour) was also recorded. We then swapped treatments, creating a paired experimental design. Ferrets under control conditions lay awake with their eyes open and screeched significantly more, but slept and sat/stood less, than following playtime. They also contacted negative and ambiguous stimuli for significantly longer under control conditions than following playtime; contact with positive stimuli showed no effects. Attempts to blind the observer to treatments were unsuccessful, so replication is required, but the findings suggest that playtime may have reduced both sub-optimal arousal and restless sensation-seeking behaviour, consistent with reducing boredom

Big Data Analytics, Infectious Diseases and Associated Ethical Impacts

The exponential accumulation, processing and accrual of big data in healthcare are only possible through an equally rapidly evolving field of big data analytics. The latter offers the capacity to rationalize, understand and use big data to serve many different purposes, from improved services modelling to prediction of treatment outcomes, to greater patient and disease stratification. In the area of infectious diseases, the application of big data analytics has introduced a number of changes in the information accumulation models. These are discussed by comparing the traditional and new models of data accumulation. Big data analytics is fast becoming a crucial component for the modelling of transmission—aiding infection control measures and policies—emergency response analyses required during local or international outbreaks. However, the application of big data analytics in infectious diseases is coupled with a number of ethical impacts. Four key areas are discussed in this paper: (i) automation and algorithmic reliance impacting freedom of choice, (ii) big data analytics complexity impacting informed consent, (iii) reliance on profiling impacting individual and group identities and justice/fair access and (iv) increased surveillance and population intervention capabilities impacting behavioural norms and practices. Furthermore, the extension of big data analytics to include information derived from personal devices, such as mobile phones and wearables as part of infectious disease frameworks in the near future and their potential ethical impacts are discussed. Considered together, the need for a constructive and transparent inclusion of ethical questioning in this rapidly evolving field becomes an increasing necessity in order to provide a moral foundation for the societal acceptance and responsible development of the technological advancement

‘Should a mammographic screening programme carry the warning: Screening can damage your health!’?

The balanced presentation afforded by convening a Citizens' Jury when considering a major question such as the introduction of a breast screening programme is advocated. This method would enable account to be taken of all the costs, both human and financial, to all those affected, both participating and organizing, as well as the benefits. Provision of such a democratic opportunity enables consideration to be given to a broad range of factors, by selection of an appropriate range of witnesses, with the advantage of involving the lay public in this decision-making process. Attendance by health correspondents, medical journalists and other media representatives enables publicization of a democracy in action whilst helping to inform the wider debate. Such an exercise could inform whether the NHS BSP should continue in its current form. © 1999 Cancer Research Campaig

A translational framework for public health research

<p><b>Background</b></p> <p>The paradigm of translational medicine that underpins frameworks such as the Cooksey report on the funding of health research does not adequately reflect the complex reality of the public health environment. We therefore outline a translational framework for public health research.</p> <p><b>Discussion</b></p> <p>Our framework redefines the objective of translation from that of institutionalising effective interventions to that of improving population health by influencing both individual and collective determinants of health. It incorporates epidemiological perspectives with those of the social sciences, recognising that many types of research may contribute to the shaping of policy, practice and future research. It also identifies a pivotal role for evidence synthesis and the importance of non-linear and intersectoral interfaces with the public realm.</p> <p><b>Summary</b></p> <p>We propose a research agenda to advance the field and argue that resources for 'applied' or 'translational' public health research should be deployed across the framework, not reserved for 'dissemination' or 'implementation'.</p&gt

‘Single‐handed care’ initiatives and reviews of double‐handed homecare packages: A survey of practices in English local authorities with adult social care responsibilities

International health and social care systems are experiencing unprecedented pressure and demand. ‘Single‐handed care’ initiatives seek to identify whether all or part of a homecare package involving more than one care worker can be safely reduced to a single worker. Little is known about these initiatives across local authorities. The aim of this study was to identify, describe and explain current processes and practices for single‐handed care initiatives and double‐handed homecare reviews. An electronic survey link was sent to each local authority with social care responsibilities in England. The questions covered a range of areas in relation to single‐handed care processes and included a combination of pre‐coded and free‐text responses. Responses were received from 76 (50%) local authorities. Findings were that over 12,000 reviews were reported within a year with a median of 141 (IQR 45–280) from 53 authorities that provided figures. Reviews were usually led by a local authority occupational therapist. On average, 540 min was spent per review, including conducting and organising the review, documentation, and travel. In nearly half the authorities, double handed care remained at least partially in place following at least 80% of the reviews and remained wholly in place following at least 60%. Local authorities also reported some resistance from homecare providers when implementing single‐handed care. The findings have confirmed anecdotal evidence that reviews of double‐handed homecare packages are common practice within local authorities. Given the amount of time taken with these reviews, and paucity of evidence on outcomes for people receiving them, further research should evaluate this

Should a colon cancer screening decision aid include the option of no testing? A comparative trial of two decision aids

<p>Abstract</p> <p>Background</p> <p>An important question in the development of decision aids about colon cancer (CRC) screening is whether to include an explicit discussion of the option of not being screened. We examined the effect of including or not including an explicit discussion of the option of deciding not to be screened in a CRC screening decision aid on subjective measures of decision aid content; interest in screening; and knowledge.</p> <p>Methods</p> <p>Adults ages 50–85 were assigned to view one of two versions of the decision aid. The two versions differed only in the inclusion of video segments of two men, one of whom decided against being screened. Participants completed questionnaires before and after viewing the decision aid to compare subjective measures of content, screening interest and intent, and knowledge between groups. Likert response categories (5-point) were used for subjective measures of content (eg. clarity, balance in favor/against screening, and overall rating), and screening interest. Knowledge was measured with a three item index and individual questions. Higher scores indicated favorable responses for subjective measures, greater interest, and better knowledge. For the subjective balance, lower numbers were associated with the impression of the decision aid favoring CRC screening.</p> <p>Results</p> <p>57 viewed the "with" version which included the two segments and 49 viewed the "without" version. After viewing, participants found the "without" version to have better subjective clarity about benefits of screening ("with" 3.4, "without" 4.1, <it>p </it>< 0.01), and to have greater clarity about downsides of screening ("with" 3.2, "without" 3.6, <it>p </it>= 0.03). The "with" version was considered to be less strongly balanced in favor of screening. ("with" 1.8, "without" 1.6, <it>p </it>= 0.05); but the "without" version received a better overall rating ("with" 3.5, "without" 3.8, <it>p </it>= 0.03). Groups did not differ in screening interest after viewing a decision aid or knowledge.</p> <p>Conclusion</p> <p>A decision aid with the explicit discussion of the option of deciding not to be screened appears to increase the impression that the program was not as strongly in favor of screening, but decreases the impression of clarity and resulted in a lower overall rating. We did not observe clinically important or statistically significant differences in interest in screening or knowledge.</p