Telephone or video? A review of telemedicine consultations during the COVID-19 pandemic in a spinal MSK service

A service evaluation of the move to virtual appointments during the COVID-19 pandemic

Exploring Producers\u27, Staff Members\u27, and Board Members\u27 Cognitive Frame on Decision Making in an Appalachian Organic Farming Venture

Sustainable development assistance organizations (SDAOs) aim to help producers of natural resource products move their goods and services to market. This article explores how the cognitive frames held by producers, staff, and board members in an agricultural SDAO in rural Appalachia influence organizational decision-making. This study explores identity, characterization, value, and membership frames. Data collected through semi-structured interviews with growers, staff, and board members reveal that the frames these stakeholders hold lead to the institutionalization of decision-making processes that allow organizational managers to make quick, consistent, and clear decisions while avoiding conflicts among members who hold competing frames. Simultaneously, these tacitly-supported practices are exclusionary, and they limit creativity and information exchange, as well as reducing transparency. Consequently, the SDAO may face organizational challenges due to limited problem-solving and adaptive management capabilities. Additionally, the prevailing nature of some members’ frames may prevent other participants from changing their views of the SDAO, limiting the firm’s flexibility to experiment with new management and organizational structures and resilience in the face of change

In situ observations of trophic behaviour and locomotion of Princaxelia amphipods (Crustacea, Pardaliscidae) at hadal depths in four West Pacific Trenches

Peer reviewedPublisher PD

State of Art of meat inspection of pigs in the EU

The current meat inspection in the European Union (EU) is based on principles that are around 100 years old. However, the zoonotic hazards have shifted and the production systems for livestock are changing. This makes it necessary to look at whether the present way of conducting meat inspection is efficient or not

Twelve-month prevalence of haemarthrosis and joint disease using the Haemophilia Joint Health score: evaluation of the UK National Haemophilia Database and Haemtrack patient reported data: an observational study

Objectives: To report the 12-month prevalence of joint bleeds from the National Haemophilia Database (NHD) and Haemtrack, a patient-reported online treatment diary and concurrent joint disease status using the haemophilia joint health score (HJHS) at individual joint level, in children and adults with severe haemophilia A and B (HA/HB) without a current inhibitor. Design: A 2018 retrospective database study of NHD from which 2238 cases were identified, 463 patients had fully itemised HJHS of whom 273 were compliant in recording treatment using Haemtrack. Setting: England, Wales and Scotland, UK. Participants: Children (<18 years) and adults (≥18 years) with severe HA and HB (factor VIII/factor IX, <0.01 iu/mL) without a current inhibitor. Primary and secondary outcomes: Prevalence of joint haemarthrosis and concurrent joint health measured using the HJHS. Results: The median (IQR) age of children was 10 (6-13) and adults 40 (29-50) years. Haemarthrosis prevalence in HA/HB children was 33% and 47%, respectively, and 60% and 42%, respectively, in adults. The most common site of haemarthrosis in children was the knee in HA and ankle in HB. In adults, the incidence of haemarthrosis at the ankles and elbows was equal. The median total HJHS in HA/HB children was 0 and in adults with HA/HB, were 18 and 11, respectively. In adults with HA/HB, the median ankle HJHS of 4.0 was higher than the median HJHS of 1.0 for both the knee and elbow. Conclusion: Despite therapeutic advances, only two-thirds of children and one-third of adults were bleed-free, even in a UK cohort selected for high compliance with prophylaxis. The median HJHS of zero in children suggests joint health is relatively unaffected during childhood. In adults, bleed rates were highest in ankles and elbows, but the ankles led to substantially worse joint health scores

ρ\rho - nucleus bound states in Walecka model

Possible formation of $\rho$ nucleus bound state is studied in the framework of Walecka model. The bound states are found in different nuclei ranging from $^3He$ to $^{208}Pb$. These bound states may have a direct bearing on the recent experiments on the photoproduction of $\rho$ meson in the nuclear medium.Comment: RevTeX fil

Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel

Aim: For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia-related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript. Methods: Fifteen HCPs experienced in the management of PwHA in the UK participated in a three-round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert-scale questions, and ≥70% selecting the same option for multiple- or single-choice questions. Questions not reaching consensus were revised for the next round. Results: 26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20-30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50-150 IU/dL) FVIII levels. Conclusion: The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs

Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel

\ua9 2024 The Authors. Haemophilia published by John Wiley &amp; Sons Ltd.Aim: For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia-related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript. Methods: Fifteen HCPs experienced in the management of PwHA in the UK participated in a three-round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert-scale questions, and ≥70% selecting the same option for multiple- or single-choice questions. Questions not reaching consensus were revised for the next round. Results: 26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20–30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50–150 IU/dL) FVIII levels. Conclusion: The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs

Treatment regimens and outcomes in severe and moderate haemophilia A in the UK: The THUNDER study

Introduction The THUNDER study provides an analysis of treatment patterns and outcomes in UK patients with severe or moderate haemophilia A (SHA/MHA) in 2015. Methods Patients with SHA or MHA registered with the UK National Haemophilia Database (NHD) were segregated by severity, inhibitor status and age. Haemophilia joint health score (HJHS) was derived from NHD records and treatment regimen and annualized bleed/joint‐bleed rate (ABR/AJBR) from Haemtrack (HT) in HT‐compliant patients. Results We report 1810 patients with SHA and 864 with MHA. Prophylaxis was used in 94.9% (n = 130/137) of HT‐compliant children <12 years with SHA, falling to 74.1% (n = 123/166) aged ≥40 years. Median ABR increased with age (1.0, IQR 0.0‐5.0, <12 years; 3.0 IQR, 1.0‐8.0, ≥40 years). Inhibitors were present in 159 (8.8%) SHA and 34 (3.9%) MHA. Median ABR increased from 2.0 (<12 years) to 21.0 (≥40 years) in SHA inhibitor patients using prophylaxis. Prophylaxis was used by 68.8% of HT‐compliant MHA patients (n = 106) (median FVIII baseline 0.01 IU/mL) associated with a median (IQR) ABR of 3.0 (1.0‐7.0). Median HJHS (n = 453) increased with age in SHA and MHA. Median (IQR) HJHS was higher in SHA inhibitor (17.0, 0.0‐64.5) than non‐ or past inhibitor patients (7.0, 0.0‐23.0). Conclusions Increasing ABR with age persists despite current prophylaxis regimens. SHA and MHA had similar ABR/AJBR and HJHS, leading to a suspicion that a subgroup of MHA may be relatively undertreated. More intensive prophylaxis may improve outcomes, but this requires further study

Vitamin A, carotenoid and vitamin E plasma concentrations in children from Laos in relation to sex and growth failure

BACKGROUND: Deficiencies of vitamin A and its precursors, the carotenoids are common problems in developing countries. Plasma levels of these components are used as biomarkers of their availability. The study was conducted to evaluate whether blood plasma obtained from capillaries can be compared with plasma obtained from venous blood with regard to its levels of retinol, carotenoids and α-tocopherol and secondly to apply this technique to evaluate the levels of these components in children in a region with possible deficiencies. METHODS: The survey was conducted in a region of Laos in 81 children (age 35 to 59 months). Dietary intake was assessed by a questionnaire. Retinol, carotenoids and α-tocopherol were determined by HPLC. Blood plasma was obtained either from capillary blood collected into microcapillaries and for reasons of methodological comparison in 14 adults from venous blood. RESULTS: The comparison between capillary and venous blood revealed that all components except zeaxanthin were 9 – 23 % higher in plasma obtained from capillary blood. Results in Laotian children showed that all investigated components except retinol were significantly lower (P < 0.01) compared to European children of slightly older age. Contrary to children in Europe, most components were significantly lower in boys compared to girls. In children from Laos, lutein was the dominant carotenoid, while in children in Europe, β-carotene was dominant. Within the Laotian children only a few differences were observed between stunted and non-stunted children and between children from lowland areas and high land areas. CONCLUSIONS: Results show that in consideration of slightly lower levels than in venous blood, capillary blood can be used to evaluate retinol, carotenoids and α-tocopherol as biomarkers of intake or status and to evaluate the possible effect of diet on absolute and relative carotenoid composition in children from Europe and Laos. Observed sex related differences might not be related to diet and would need further investigation