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Multiplex antigen near-patient tests (NPTs) can detect multiple virus-specific antigens during acute infection. This project aimed to provide an overview of evidence on the effectiveness, advantages and disadvantages, and feasibility of multiplex antigen NPTs to identify common respiratory pathogens (including SARS-CoV-2 and one or both of the influenza and respiratory syncytial viruses) in residential and primary care settings.
Methods
A non-systematic literature search was conducted on the 28 July 2023 in the MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases to identify relevant literature. National and international agency websites were searched for guidance or recommendations relating to multiplex antigen NPTs. Relevant citations were screened and extracted by one reviewer and cross-checked by a second reviewer. Health technology assessments, systematic reviews, observational studies, and randomized and non-randomized controlled trials were considered eligible for inclusion in the overview. No formal quality appraisal of included documents was conducted. Due to the variation in study types, study findings were narratively assessed.
Results
Ten documents were identified in total. One complete prospective evaluation and seven incomplete clinical trials were identified. No relevant primary studies were identified for effectiveness outcomes such as time to appropriate treatment with antibiotics or antivirals. An evaluation published by the Haute Autorité de Santé in France reported that there was insufficient performance data regarding multiplex antigen NPTs in clinical practice. In a joint statement on respiratory virus testing, the Public Health Laboratory Network and Communicable Diseases Network in Australia indicated that antigen NPTs were not recommended due to their poor ability to identify influenza A.
Conclusions
Evidence on the effectiveness, advantages, disadvantages, and feasibility of multiplex antigen NPTs to detect common respiratory pathogens in primary and residential care settings is sparse. Studies are required to assess the diagnostic performance (relative to reverse transcription polymerase chain reaction tests) and clinical utility of multiplex antigen NPTs in residential and primary care settings.
Family members of people experiencing a first-episode psychosis (FEP) can experience high levels of carer burden, stigma, emotional challenges, and uncertainty. This indicates the need for support and psychoeducation. To address these needs during the COVID-19 pandemic, we developed a multidisciplinary, blended, telehealth intervention, incorporating psychoeducation and peer support, for family members of FEP service users: PERCEPTION (PsychoEducation for Relatives of people Currently Experiencing Psychosis using Telehealth, an In-person meeting, and ONline peer support). The aim of the study was to explore the acceptability of PERCEPTION for family members of people who have experienced an FEP.
Methods:
Ten semi-structured interviews were conducted online via Zoom and audio recorded. Maximum variation sampling was used to recruit a sample balanced across age, gender, relatives’ prior mental health service use experience, and participants’ relationship with the family member experiencing psychosis. Data were analysed by hand using reflexive thematic analysis.
Results:
Four themes were produced: ‘Developing confidence in understanding and responding to psychosis’; ‘Navigating the small challenges of a broadly acceptable and desirable intervention’; ‘Timely support enriches the intervention’s meaning’; and ‘Dealing with the realities of carer burden’.
Conclusions:
Broadly speaking, PERCEPTION was experienced as acceptable, with the convenient, safe, and supportive environment, and challenges in engagement being highlighted by participants. Data point to a gap in service provision for long-term self-care support for relatives to reduce carer burden. Providing both in-person and online interventions, depending on individuals’ preference and needs, may help remove barriers for family members accessing help.
We report the case of a 13-day-old infant with enteroviral myocarditis surviving an out-of-hospital cardiac arrest. She underwent orthotopic cardiac transplantation three months later. A year after the transplantation, she is alive and well. Enteroviral infection is common in neonates with high mortality in cases of enteroviral myocarditis. Cardiac transplantation is a treatment option for infants who fail to recover and remain dependent on inotropic support. This is the first report of an infant with out-of-hospital cardiac arrest secondary to enteroviral myocarditis surviving up to cardiac transplantation.
We have assessed the utility of morphological and microsatellite markers for tracing field hybridization between Lolium multiflorum and Lolium perenne in cereal-enclosed gene flow plots. The presence of awns on the inflorescence of F1 hybrids was found to be a reliable, but underscoring, indicator of L. multiflorum paternity in L. perenne derived seed as determined by inheritance of species-specific alleles at the microsatellite locus ‘H01 H06’ in these progeny. A positive correlation was evident in the experimental treatment between the number of pollen donor plants in a given plot and the frequency of hybrid F1 seed harvested from pollen receptor plants in that plot. These experiments have established the utility of naturally occurring heritable markers for the measurement of gene flow rates in field Ryegrass populations, with particular significance for risk assessment modeling of potential gene flow from transgenic grass cultivars.
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