171 research outputs found
A five-year review of quality of reporting of research using clinician surveys in high-ranked dermatology journals
Surveys of clinicians play a pivotal role in dermatology research, including to determine expert opinion, identify areas of uncertainty in clinical practice, define research priorities, investigate feasibility and explore areas of clinical equipoise. Despite the commonality of research involving surveys distributed to dermatologists, we previously identified the issue of poorâquality survey design and lack of sufficient validation prior to distribution. Furthermore, a review of postal surveys of healthcare professionals from 1996 to 2005 has shown declining response rates, introducing potential nonâresponder bias. To support stronger methodological quality and reporting of clinician survey, we developed a checklist for authors, based on our experience and published literature
Consent for the diagnosis of preclinical dementia states:A review
It is now possible to detect the pathology of Alzheimer's disease (AD) many years before symptoms and signs otherwise become manifest. Biomarkers of disease include evidence of amyloid and tau in the cerebrospinal fluid and neuroimaging which (for instance) allows amyloid in the brain to be visualized. There is, thus, a preclinical state in which it is possible to identify Alzheimer's pathology long before there is clinical evidence of disease. Much research focuses on this preclinical state because it seems likely that treatments will be more effective before the disease is established. This means that researchers can discover Alzheimer's pathology some years before the person is at risk of developing the condition. In memory clinics, too, people may present with early (prodromal) symptoms which do not yet amount to a dementia syndrome (e.g. mild cognitive impairment), yet biomarker evidence that dementia is highly likely to develop. This is problematic because people will be required to consent to the disclosure of findings that indicate an uncertain risk of an alarming disease. We carried out a scoping review of the issues that arise in connection with a "diagnosis" of preclinical dementia. We identified four themes in the literature: stigma; ethical issues; psychological burden; and language. We shall discuss these themes and related issues that emerge to do with meaning, medicalization, virtues and values. More research is now required to understand these issues in detail, where the emphasis should be on the breadth of research, which must be biopsychosocial and ethical.</p
Consent for the diagnosis of preclinical dementia states:A review
It is now possible to detect the pathology of Alzheimer's disease (AD) many years before symptoms and signs otherwise become manifest. Biomarkers of disease include evidence of amyloid and tau in the cerebrospinal fluid and neuroimaging which (for instance) allows amyloid in the brain to be visualized. There is, thus, a preclinical state in which it is possible to identify Alzheimer's pathology long before there is clinical evidence of disease. Much research focuses on this preclinical state because it seems likely that treatments will be more effective before the disease is established. This means that researchers can discover Alzheimer's pathology some years before the person is at risk of developing the condition. In memory clinics, too, people may present with early (prodromal) symptoms which do not yet amount to a dementia syndrome (e.g. mild cognitive impairment), yet biomarker evidence that dementia is highly likely to develop. This is problematic because people will be required to consent to the disclosure of findings that indicate an uncertain risk of an alarming disease. We carried out a scoping review of the issues that arise in connection with a "diagnosis" of preclinical dementia. We identified four themes in the literature: stigma; ethical issues; psychological burden; and language. We shall discuss these themes and related issues that emerge to do with meaning, medicalization, virtues and values. More research is now required to understand these issues in detail, where the emphasis should be on the breadth of research, which must be biopsychosocial and ethical.</p
Population size of Oystercatchers Haematopus ostralegus wintering in Iceland
The first ever survey of Oystercatchers wintering in Iceland found around 11 000 individuals. This is an estimated 30% of the Icelandic population, including juveniles, suggesting that approximately 26 000 Icelandic Oystercatchers migrate to western Europe in the autumn. More Oystercatchers winter in Iceland than at similar latitudes elsewhere in Europe, which may reflect the remoteness and milder winter temperatures on this oceanic island
Evaluating the evidence base: Policies and interventions to address socioeconomic status gradients in health a
This chapter discusses the current evidence base for policies that could address socioeconomic status (SES) health gradients in the United States. The present volume has documented an enormous amount of research on the linkages between SES and health, but there are still relatively few studies that rigorously establish the effectiveness of particular policies or interventions in reducing those gradients. Given the difficulty in developing randomized evidence for many types of interventions related to social determinants of health, we argue for conducting policy analysis from a Bayesian perspective. This Bayesian approach combines information on best available theory and evidence regarding probable health benefits and costs of an intervention, providing a framework that also incorporates the probable costs of inaction. The second half of the chapter adopts a ladder metaphor to classify policies and interventions that could reduce SES gradients in population health. Using this framework, we consider the evidence base for various types of policies, focusing primarily on the social determinants of health, under the rubric that âall policy is health policy.â We conclude by discussing promising strategies for future strengthening of the evidence base for policy, including the role of health impact assessment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78585/1/j.1749-6632.2009.05386.x.pd
Broadâscale patterns of the AfroâPalaearctic landbird migration
Aim: Knowledge of broad-scale biogeographical patterns of animal migration is important for understanding ecological drivers of migratory behaviours. Here, we present a flyway-scale assessment of the spatial structure and seasonal dynamics of the Afro-Palaearctic bird migration system and explore how phenology of the environment guides long-distance migration. Location: Europe and Africa. Time period: 2009â2017. Major taxa studied: Birds. Methods: We compiled an individual-based dataset comprising 23 passerine and near-passerine species of 55 European breeding populations, in which a total of 564 individuals were tracked during migration between Europe and sub-Saharan Africa. In addition, we used remotely sensed primary productivity data (the normalized difference vegetation index) to estimate the timing of vegetation green-up in spring and senescence in autumn across Europe. First, we described how individual breeding and non-breeding sites and the migratory flyways link geographically. Second, we examined how the timing of migration along the two major Afro-Palaearctic flyways is tuned with vegetation phenology at the breeding sites. Results: We found the longitudes of individual breeding and non-breeding sites to be related in a strongly positive manner, whereas the latitudes of breeding and non-breeding sites were related negatively. In autumn, migration commenced ahead of vegetation senescence, and the timing of migration was 5â7 days earlier along the Western flyway compared with the Eastern flyway. In spring, the time of arrival at breeding sites was c. 1.5 days later for each degree northwards and 6â7 days later along the Eastern compared with the Western flyway, reflecting the later spring green-up at higher latitudes and more eastern longitudes. Main conclusions: Migration of the Afro-Palaearctic landbirds follows a longitudinally parallel leapfrog migration pattern, whereby migrants track vegetation green-up in spring but depart before vegetation senescence in autumn. The degree of continentality along migration routes and at the breeding sites of the birds influences the timing of migration on a broad scale
Emergence of a Novel Avian Pox Disease in British Tit Species
Avian pox is a viral disease with a wide host range. In Great Britain, avian pox in birds of the Paridae family was first diagnosed in a great tit (Parus major) from south-east England in 2006. An increasing number of avian pox incidents in Paridae have been reported each year since, indicative of an emergent infection. Here, we utilise a database of opportunistic reports of garden bird mortality and morbidity to analyse spatial and temporal patterns of suspected avian pox throughout Great Britain, 2006â2010. Reports of affected Paridae (211 incidents) outnumbered reports in non-Paridae (91 incidents). The majority (90%) of Paridae incidents involved great tits. Paridae pox incidents were more likely to involve multiple individuals (77.3%) than were incidents in non-Paridae hosts (31.9%). Unlike the small wart-like lesions usually seen in non-Paridae with avian pox in Great Britain, lesions in Paridae were frequently large, often with an ulcerated surface and caseous core. Spatial analyses revealed strong clustering of suspected avian pox incidents involving Paridae hosts, but only weak, inconsistent clustering of incidents involving non-Paridae hosts. There was no spatial association between Paridae and non-Paridae incidents. We documented significant spatial spread of Paridae pox from an origin in south-east England; no spatial spread was evident for non-Paridae pox. For both host clades, there was an annual peak of reports in August/September. Sequencing of the avian poxvirus 4b core protein produced an identical viral sequence from each of 20 great tits tested from Great Britain. This sequence was identical to that from great tits from central Europe and Scandinavia. In contrast, sequence variation was evident amongst virus tested from 17 non-Paridae hosts of 5 species. Our findings show Paridae pox to be an emerging infectious disease in wild birds in Great Britain, apparently originating from viral incursion from central Europe or Scandinavia
Shorebirds as important vectors for plant dispersal in Europe
Shorebirds (Charadriiformes) undergo rapid migrations with potential for long-distance dispersal (LDD) of plants. We studied the frequency of endozoochory by shorebirds in different parts of Europe covering a broad latitudinal range and different seasons. We assessed whether plants dispersed conformed to morphological dispersal syndromes. A total of 409 excreta samples (271 faeces and 138 pellets) were collected from redshank Tringa totanus, black-winged stilt Himantopus himantopus, pied avocet Recurvirostra avosetta, northern lapwing Vanellus vanellus, Eurasian curlew Numenius arquata and black-tailed godwit Limosa limosa in south-west Spain, north-west England, southern Ireland and Iceland in 2005 and 2016, and intact seeds were extracted and identified. Godwits were sampled just before or after migratory movements between England and Iceland. The germinability of seeds was tested. Intact diaspores were recovered from all bird species and study areas, and were present in 13% of samples overall. Thirteen plant families were represented, including Charophyceae and 26 angiosperm taxa. Only four species had an âendozoochory syndromeâ. Four alien species were recorded. Ellenberg values classified three species as aquatic and 20 as terrestrial. Overall, 89% of seeds were from terrestrial plants, and 11% from aquatic plants. Average seed length was higher in redshank pellets than in their faeces. Six species were germinated, none of which had an endozoochory syndrome. Seeds were recorded during spring and autumn migration. Plant species recorded have broad latitudinal ranges consistent with LDD via shorebirds. Crucially, morphological syndromes do not adequately predict LDD potential, and more empirical work is required to identify which plants are dispersed by shorebirds. Incorporating endozoochory by shorebirds and other migratory waterbirds into plant distribution models would allow us to better understand the natural processes that facilitated colonization of oceanic islands, or to improve predictions of how plants will respond to climate change, or how alien species spread.Peer Reviewe
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