Animal hoarding cases in England: Implications for public health services

Hoarding disorder is characterized by an accumulation of possessions due to excessive acquisition of or difficulty discarding possessions, regardless of their actual value and is estimated to affect 2–6% of the population. Animal hoarding, a distinct subset of hoarding disorder, has a significant public health impact on the humans involved, as well as animal welfare. Individuals exhibit self-neglect, apathy, social withdrawal and object hoarding; living within squalid, deteriorated, structurally unsafe and uninhabitable premises, alongside neglected animals. Cases are complex, costly and impact on a range of responding service providers. Effective case management is poorly understood and researched, with published literature in England particularly sparse. Improving understanding of the characteristics of these cases is the first step in informed case management. This research is the first exploration of the characteristics of animal hoarders in England and the areas where cases were located. Information about prosecutions involving large numbers of animals that were reported in the media was systematically obtained. This identified 66 cases between January 2015 and December 2020. Geospatial analysis exploring characteristics of locations where animal hoarding cases are also reported. Findings were broadly consistent with the international literature in that females (64%), those living alone (71%) and those with a mean age of 49 were well represented. Cats (61.5%) and dogs (60%) were the most commonly hoarded species. There was a mean of 44 animals per case and dead or animals requiring euthanasia found in 53% of cases. Key characteristics of the areas where cases were found highlight urban, densely populated, and high levels of deprivation being the most represented. Evidence of recidivism was evident in 39% of cases, suggesting that prosecution is not an effective rehabilitator. Animal hoarding raises serious implications for Public Health Services, and the lack of current effective case management strategies are discussed

HiTRACE: High-throughput robust analysis for capillary electrophoresis

Motivation: Capillary electrophoresis (CE) of nucleic acids is a workhorse technology underlying high-throughput genome analysis and large-scale chemical mapping for nucleic acid structural inference. Despite the wide availability of CE-based instruments, there remain challenges in leveraging their full power for quantitative analysis of RNA and DNA structure, thermodynamics, and kinetics. In particular, the slow rate and poor automation of available analysis tools have bottlenecked a new generation of studies involving hundreds of CE profiles per experiment. Results: We propose a computational method called high-throughput robust analysis for capillary electrophoresis (HiTRACE) to automate the key tasks in large-scale nucleic acid CE analysis, including the profile alignment that has heretofore been a rate-limiting step in the highest throughput experiments. We illustrate the application of HiTRACE on thirteen data sets representing 4 different RNAs, three chemical modification strategies, and up to 480 single mutant variants; the largest data sets each include 87,360 bands. By applying a series of robust dynamic programming algorithms, HiTRACE outperforms prior tools in terms of alignment and fitting quality, as assessed by measures including the correlation between quantified band intensities between replicate data sets. Furthermore, while the smallest of these data sets required 7 to 10 hours of manual intervention using prior approaches, HiTRACE quantitation of even the largest data sets herein was achieved in 3 to 12 minutes. The HiTRACE method therefore resolves a critical barrier to the efficient and accurate analysis of nucleic acid structure in experiments involving tens of thousands of electrophoretic bands.Comment: Revised to include Supplement. Availability: HiTRACE is freely available for download at http://hitrace.stanford.ed

Effect of NADPH oxidase 1 and 4 blockade in activated human retinal endothelial cells

© 2018 Royal Australian and New Zealand College of Ophthalmologists. This author accepted manuscript is made available following 12 month embargo from date of publication (January 2018) in accordance with the publisher's archiving policy.Background Over‐production of reactive oxygen species (ROS) and resulting oxidative stress contribute to retinal damage in vascular diseases that include diabetic retinopathy, retinopathy of prematurity and major retinal vessel occlusions. NADPH oxidase (Nox) proteins are professional ROS‐generating enzymes, and therapeutic targeting in these diseases has strong appeal. Pharmacological inhibition of Nox4 reduces the severity of experimental retinal vasculopathy. We investigated the potential application of this drug approach in humans. Methods Differential Nox enzyme expression was studied by real‐time‐quantitative polymerase chain reaction in primary human retinal endothelial cell isolates and a characterized human retinal endothelial cell line. Oxidative stress was triggered chemically in endothelial cells, by treatment with dimethyloxalylglycine (DMOG; 100 μM); Nox4 and vascular endothelial growth factor (VEGFA) transcript were measured; and production of ROS was detected by 2′,7′‐dichlorofluorescein. DMOG‐stimulated endothelial cells were treated with two Nox1/Nox4 inhibitors, GKT136901 and GKT137831; cell growth was monitored by DNA quantification, in addition to VEGFA transcript and ROS production. Results Nox4 (isoform Nox4A) was the predominant Nox enzyme expressed by human retinal endothelial cells. Treatment with DMOG significantly increased endothelial cell expression of Nox4 over 72 h, accompanied by ROS production and increased VEGFA expression. Treatment with GKT136901 or GKT137831 significantly reduced DMOG‐induced ROS production and VEGFA expression by endothelial cells, and the inhibitory effect of DMOG on cell growth. Conclusions Our findings in experiments on activated human retinal endothelial cells provide translational corroboration of studies in experimental models of retinal vasculopathy and support the therapeutic application of Nox4 inhibition by GKT136901 and GKT137831 in patients with retinal vascular diseases

Prevalence and Determinants of Vitamin D Deficiency in 1825 Cape Town Primary Schoolchildren: A Cross-Sectional Study

Vitamin D deficiency (25-hydroxyvitamin D[25(OH)D] <50 nmol/L) is common among adults in Cape Town, South Africa, but studies investigating vitamin D status of children in this setting are lacking. We conducted a cross-sectional study to determine the prevalence and determinants of vitamin D deficiency in 1825 Cape Town schoolchildren aged 6–11 years. Prevalence of vitamin D deficiency was 7.6% (95% Confidence Interval [CI] 6.5% to 8.9%). Determinants of vitamin D deficiency included month of sampling (adjusted odds ratio [aOR] for July–September vs. January–March 10.69, 95% CI 5.02 to 22.77; aOR for October–December vs. January–March 6.73, 95% CI 2.82 to 16.08), older age (aOR 1.25 per increasing year, 95% CI: 1.01–1.53) and higher body mass index (BMI; aOR 1.24 per unit increase in BMI-for-age Z-score, 95% CI: 1.03–1.49). In a subset of 370 participants in whom parathyroid hormone (PTH) concentrations were measured; these were inversely related to serum 25(OH)D concentrations (p < 0.001). However, no association between participants with hyperparathyroidism (PTH >6.9 pmol/L) and vitamin D deficiency was seen (p = 0.42). In conclusion, we report that season is the major determinant of vitamin D status among Cape Town primary schoolchildren, with prevalence of vitamin D deficiency ranging from 1.4% in January–March to 22.8% in July–September

The subjective world of home care workers in dementia: an “order of worth” analysis

The perspective of domiciliary workers is needed to recruit a high-quality workforce and meet growing demand. An English ethnographic study yielded extensive insights. To structure analysis of the study data, we apply a method developed by political theorists Boltanski and Thévenot that identifies key variables in different values systems. This “orders of worth” framework is used to map out the distinctive features of the subjective world of home carers. The results can be drawn on to formulate recruitment and retention policies, to design reward strategies or to ensure that training and education opportunities engage effectively with the workforce

'Going the extra mile' for older people with dementia: Exploring the voluntary labour of homecare workers.

Homecare workers provide essential physical, social and emotional support to growing numbers of older people with dementia in the UK. Although it is acknowledged that the work can sometimes be demanding, some homecare workers regularly 'go the extra mile' for service users, working above and beyond the usual remit of the job. This form of voluntarism has been interpreted as an expression of an essentially caring nature, but also as the product of a work environment structured to tacitly endorse the provision of unpaid labour. This paper draws on a qualitative study of what constitutes 'good' homecare for older people with dementia. Using homecare workers' reflexive diaries ( n = 11) and interviews with homecare workers ( n = 14) and managers ( n = 6), we explore manifestations of, and motivations for, homecare workers going the extra mile in their everyday work. We describe three modes of voluntary labour based on these accounts which we characterise as affective, performative and pragmatic. Our study highlights the complex relationships between job satisfaction, social benefit and commercial gain in the homecare work sector. Further research is needed to define the full range of affective and technical skills necessary to deliver good homecare, and to ensure that homecare work is appropriately credited

Functional immune responses against SARS-CoV-2 variants of concern after fourth COVID-19 vaccine dose or infection in patients with blood cancer

Summary Patients with blood cancer continue to have a greater risk of inadequate immune responses following three COVID-19 vaccine doses and risk of severe COVID-19 disease. In the context of the CAPTURE study (NCT03226886) we report immune responses in 80 patients with blood cancer who received a fourth dose of BNT162b2. We measured neutralising antibody titres (NAbT) using a live virus microneutralization assay against wild-type (WT), Delta, Omicron BA.1 and BA.2 and T cell responses against WT and Omicron BA.1 using an activation-induced marker (AIM) assay. The proportion of patients with detectable NAb titres and T cell responses after the fourth vaccine dose increases compared to those after the third vaccine dose. Patients who received B cell-depleting therapies within 12 months before vaccination have the greatest risk of not having detectable NAbT. In addition, we report immune responses in 57 patients with breakthrough infections after vaccination

Vitamin D supplementation to prevent tuberculosis infection in South African schoolchildren: multicentre phase 3 double-blind randomised placebo-controlled trial (ViDiKids)

BACKGROUND: Relationships between vitamin D status, parathyroid hormone (PTH), bone mineral content (BMC) and fracture risk differ between children of White European vs. Black African ancestry. However, randomised controlled trials (RCT) to determine the influence of vitamin D supplements on BMC and fracture risk in African children are lacking.   METHODS: We conducted a sub-study nested within a Phase 3 RCT of weekly oral supplementation with 10,000 IU vitamin D3 in Cape Town schoolchildren aged 6-11 years. Sub-study outcomes were BMC at the whole body minus head and lumbar spine sites, determined by dual-energy x-ray absorptiometry (DXA), serum concentrations of 25-hydroxyvitamin D3 (25[OH]D3), PTH, alkaline phosphatase (ALP), C-terminal telopeptide (CTX) and procollagen type 1 N propeptide (P1NP). Incidence of fractures was a secondary outcome of the main trial.   FINDINGS: 1682 children of Black African ancestry attending 23 schools were enrolled in the main trial (829 vs. 853 randomised to vitamin D vs. placebo, respectively) of whom 450 also participated in the nested sub-study (228 vs. 222 randomised to vitamin D vs. placebo, respectively). In the sub-study population, end-trial serum concentrations of 25(OH)D3 were higher for participants allocated to vitamin D vs. placebo (adjusted mean difference [aMD] 39.9 nmol/L, 95% CI 36.1 to 43.6 nmol/L, P<0.001) and serum PTH concentrations were lower (aMD -0.55 pmol/L, 95% CI -0.94 to -0.17, P=0.005). However, no interarm differences were seen for BMC at the whole body minus head (aMD -8.0 g, 95% CI -30.7 to 14.7) or the lumbar spine (aMD -0.3 g, 95% CI -1.3 to 0.8), or for serum concentrations of alkaline phosphatase, CTX or P1NP (P≥0.28). In the main trial population, allocation to vitamin D vs. placebo did not influence the proportion of participants reporting one or more fractures (adjusted odds ratio 0.70, 95% CI 0.27 to 1.85, P=0.48).   INTERPRETATION: Weekly oral supplementation with 10,000 IU vitamin D3 for 3 years elevated serum 25(OH)D3 concentrations and suppressed serum PTH concentrations among Cape Town schoolchildren of Black African ancestry but did not influence BMC, serum concentrations of bone turnover markers or fracture risk

Using a Reflective Diary Method to Investigate the Experiences of Paid Home Care Workers Caring for People With Dementia

This article reports on the use of an innovative reflective diary method with paid home care workers caring for people with dementia. It examines the key features of the diary design, recruitment and training of participants, diarists’ approaches and responses to diary-keeping, and evaluates the use of diaries in this context. Following training, 11 volunteers (all female) employed by a U.K.-based home care organization kept diaries of their experiences of caring for those with dementia. Using specially designed diaries, they wrote about their visits to clients for a period of approximately 4 months and were remunerated for up to 16 extra hours at their usual hourly rate of pay. Overall, home care workers engaged well with the process, keeping regular, lengthy, timely, and reflective diary entries. Diary-keeping provided a means for these workers to express their emotions about their work, while enhancing their self-insight and care practices. We demonstrate the feasibility of diaries for research with this occupational group and conclude that the written reflexivity employed in diaries can document, enrich, and improve the work of these caregivers