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To review patient satisfaction with the change in practice towards telephone consultations during and after the coronavirus disease 2019 pandemic for head and neck cancer follow up.
A retrospective analysis was conducted of head and neck cancer telephone appointments during a six-month period in a tertiary referral centre.
Patients found the telephone consultations beneficial (98 per cent), with 30 per cent stating they were relieved to not have to attend hospital. Patients who travelled further, those with lower stage disease and patients with a greater interval from initial treatment were most satisfied with the telephone consultations. Sixty-eight per cent of patients stated they would be happy to have telephone consultations as part of their regular follow up after the pandemic.
Patients found the telephone consultations beneficial and 30 per cent considered them preferable to face-to-face appointments. This study demonstrates that telephone consultations can be used as an adjunct to face-to-face appointments in an effort to reduce hospital attendances whilst maintaining close follow up.
The novel coronavirus, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is the causative agent of the 2020 worldwide coronavirus pandemic. Antibody testing is useful for diagnosing historic infections of a disease in a population. These tests are also a helpful epidemiological tool for predicting how the virus spreads in a community, relating antibody levels to immunity and for assessing herd immunity. In the present study, SARS-CoV-2 viral proteins were recombinantly produced and used to analyse serum from individuals previously exposed, or not, to SARS-CoV-2. The nucleocapsid (Npro) and spike subunit 2 (S2Frag) proteins were identified as highly immunogenic, although responses to the former were generally greater. These two proteins were used to develop two quantitative enzyme-linked immunosorbent assays (ELISAs) that when used in combination resulted in a highly reliable diagnostic test. Npro and S2Frag-ELISAs could detect at least 10% more true positive coronavirus disease-2019 (COVID-19) cases than the commercially available ARCHITECT test (Abbott). Moreover, our quantitative ELISAs also show that specific antibodies to SARS-CoV-2 proteins tend to wane rapidly even in patients who had developed severe disease. As antibody tests complement COVID-19 diagnosis and determine population-level surveillance during this pandemic, the alternative diagnostic we present in this study could play a role in controlling the spread of the virus.
Marteilia refringens causes marteiliosis in oysters, mussels and other bivalve molluscs. This parasite previously comprised two species, M. refringens and Marteilia maurini, which were synonymized in 2007 and subsequently referred to as M. refringens ‘O-type’ and ‘M-type’. O-type has caused mass mortalities of the flat oyster Ostrea edulis. We used high throughput sequencing and histology to intensively screen flat oysters and mussels (Mytilus edulis) from the UK, Sweden and Norway for infection by both types and to generate multi-gene datasets to clarify their genetic distinctiveness. Mussels from the UK, Norway and Sweden were more frequently polymerase chain reaction (PCR)-positive for M-type (75/849) than oysters (11/542). We did not detect O-type in any northern European samples, and no histology-confirmed Marteilia-infected oysters were found in the UK, Norway and Sweden, even where co-habiting mussels were infected by the M-type. The two genetic lineages within ‘M. refringens’ are robustly distinguishable at species level. We therefore formally define them as separate species: M. refringens (previously O-type) and Marteilia pararefringens sp. nov. (M-type). We designed and tested new Marteilia-specific PCR primers amplifying from the 3’ end of the 18S rRNA gene through to the 5.8S gene, which specifically amplified the target region from both tissue and environmental samples.
In addition to the hundreds of known visual-wavelength Diffuse Interstellar Bands (DIBs), a number of DIBs in the near-infrared (NIR) are now also known to exist. We present here high-resolution UKIRT echelle spectroscopy of two of the NIR DIBs toward sightlines exhibiting a range of visual extinctions. Variations in the strengths and profile shapes of the bands are considered in the context of known properties of the narrow DIBs at visual wavelengths.
Larger portion sizes (PS) may be inciting over-eating and contributing to obesity rates. Currently, there is a paucity of data on the effectiveness of serving size (SS) guidance. The aims of the present review are to evaluate SS guidance; the understanding, usability and acceptability of such guidance, its impact on consumers and potential barriers to its uptake. A sample of worldwide SS guidance schemes (n 87) were identified using targeted and untargeted searches, overall these were found to communicate various inconsistent and often conflicting messages about PS selection. The available data suggest that consumers have difficulty in understanding terms such as ‘portion size’ and ‘serving size’, as these tend to be used interchangeably. In addition, discrepancies between recommended SS and those present on food labels add to the confusion. Consumers generally understand and visualise SS best when expressed in terms of household measures rather than actual weights. Only a limited number of studies have examined the direct impact of SS guidance on consumer behaviour with equivocal results. Although consumers recognise that guidance on selecting SS would be helpful, they are often unwilling to act on such guidance. The challenge of achieving consumer adherence to SS guidance is formidable due to several barriers including chronic exposure to larger PS, distorted consumption norms and perceptions, the habit of ‘cleaning one's plate’ and language barriers for ethnic minorities. In conclusion, the impact of SS guidance on consumers merits further investigation to ensure that future guidance resonates with consumers by being more understandable, usable and acceptable.
We examined and described colonization of MRSA in the anterior nares and throat from 184 community-recruited injection drug users. Thirty-seven (20%) were positive for MRSA: most (34, 92%) were carriers in the nares; while only three (8%) were carriers detected by throat swabs alone. The majority (29, 78%) of MRSA isolates were PVL positive.
Injection drug users (IDUs) have an elevated risk for carriage of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Cutaneous injection-related infections are common in IDUs but detailed studies are few. Based on a subsample of 218 individuals from a community-recruited cohort of IDUs at a supervised injection facility, we investigated the microbiology and related antibiotic susceptibility profiles of isolates from 59 wounds. Twenty-seven percent of subjects had at least one wound and 25 (43%) were culture positive for S. aureus alone [14 MRSA and 11 (19%) methicillin-susceptible (MSSA) isolates]. Sixteen of 18 MRSA isolates were classified as community associated (CA) by the presence of genes encoding for PVL. MRSA and MSSA occurred in mixed infection with other organisms on three and six occasions, respectively. All CA-MRSA isolates were susceptible to tetracycline, vancomycin and linezolid but only 13% were susceptible to clindamycin compared to 63% of MSSA isolates. The frequency of CA-MRSA is a cause for concern in wound infection in the IDU setting.
Faecal egg counts were examined in 2 flocks of naturally infected Scottish Blackface sheep in southern and central Scotland. The distribution of mean counts was right skewed and similar to a gamma distribution. The counts varied with month, with mean counts rising from May to July, then falling but rising again in October, although data within each year did not always show such a clear pattern. There was no significant difference in mean egg count between the 2 farms examined. The distribution of egg count variances was also right skewed and conformed to a gamma distribution. There was a strong relationship between the mean and the variance for each population, implying that variation among populations in variances largely mirrored variation in mean egg counts. Populations with high mean egg counts and variances did not necessarily have more adult nematodes but had a greater number of adult nematodes from species other than Teladorsagia circumcincta, particularly Cooperia spp., Trichostrongylus axei and Trichostrongylus vitrinus. The contribution of different parasite species to the egg count explains the relatively poor and inconsistent fit of the negative binomial distribution to faecal egg counts in lambs.
This paper was written at the request of the Life Research Committee of the United Kingdom Actuarial Profession's Life Board. It concerns the valuation of U.K. with-profits business, with particular attention to the market-consistent ‘realistic reporting’ basis currently being used in the U.K. by the regulator, the Financial Services Authority (FSA). The paper surveys recent regulatory activity concerning the development and introduction of the new valuation approach, and puts it into the context of a survey of alternative methodologies, both deterministic and stochastic. The particular issues arising when considering prudential solvency are discussed, and various approaches are reviewed and compared with market consistent methods. Numerical examples are given, which demonstrate potential issues (regarding comparability and consistency) with the FSA's proposed approach — in particular the sensitivity of results to model calibration. The authors support the FSA's move to a stochastically-based framework for solvency measurement, but highlight some issues which need to be taken into account.
Avilamycin (AGP) and zinc oxide (ZnO) are both frequently included in the post-weaning piglet diet to enhance growth performance and prevent diarrhoea. This study investigated what effect removing these compounds from the post-weaning diet would have on the growth performance and faecal microbiota of weaned piglets. Fifty-two crossbred piglets (JSR Healthbred) were allocated, at weaning, to one of two dietary treatments on the basis of weight, litter origin and gender. The diets were (i) control (no supplemented ZnO or AGP); (ii) ZnO + AGP (supplemented with 3100 mg ZnO per kg food and 40 mg avilamycin per kg food). These diets were offered ad libitum for 20 days post weaning. Thereafter, the pigs received the same non-supplemented grower and finisher diets ad libitum. All piglets were individually weighed, and faecal samples were obtained from pre-selected piglets, at various time points throughout the trial period. Ten-fold serial dilutions of faecal material were cultured on specific media to enumerate aerobes, anaerobes, Lactobacillus spp. and Escherichia coli. ZnO + AGP supplementation enhanced weaned piglet average daily food intake (ADFI) (P < 0·001), average daily live-weight gain (ADG) (P < 0·001) and food conversion ratio (FCR) (P < 0·01) during the initial 20 days post weaning. Piglets previously supplemented with ZnO + AGP gained more weight per day during the non-supplemented grower phase (days 21 to 60) than their control counterparts (741·5 v. 672·5 g per pig per day) (P < 0·01). The bacteriological data showed that ZnO + AGP piglets had lower counts of anaerobic bacteria in their faeces than control piglets (P < 0·01). These findings indicate that dietary AGP + ZnO may enhance growth by reducing gastro-intestinal bacterial populations, and that their removal from the post-weaning diet will increase days to slaughter.
The single-trial Prisoner's Dilemma, discussed in Entry #5, is defined by the conflict between self-interest (“me”) and joint interest (“we”). An individual is always better off choosing a noncooperative option, irrespective of the partner's behavior, even though the cooperative choice is preferable from a dyadic standpoint. Choices in the “classic” case of the single-trial Prisoner's Dilemma, involving simultaneous and irrevocable choice (as in the story from which the situation takes its name), are unlikely to be influenced by past interactions or future goals. In contrast, in Iterated Prisoner's Dilemmas, behavior is likely to be affected by prior interactions and considerations regarding future interactions with the partner. This is true even when the choices at each point are simultaneous and irrevocable. The persons become able to react contingently to each other's prior behaviors and, therefore, to develop strategies for influencing each other's behavior. For example, a person is unlikely to prepare extensively for a joint working meeting if she knows that her colleague has repeatedly slacked off before in past meetings. On the other hand, a person may devote greater time and effort preparing for a joint task when anticipating future shared endeavors in order to motivate the other to enhance her performance in the future.
Iterated Prisoner's Dilemmas are common in everyday life (and are considerably more common than the single-trial Prisoner's Dilemma).
A “situation” is defined in the dictionary as “a position with respect to conditions and circumstances,” or, more generally, as a “site” or “problem.” These introductory chapters describe how, in keeping with that definition, we describe and distinguish among situations involving several persons, that is, interpersonal situations. In this chapter, we give concrete examples of a simple yet useful method for characterizing such situations, namely, the “outcome matrix,” and explain the rationale for its use. We then show the implications of that method as well as some of its limitations. Chapter 3 describes our remedies for those limitations.
This Atlas is based on a particular theory known as “interdependence theory.” It was first presented by Thibaut and Kelley (1959) and then elaborated in Kelley and Thibaut (1978) and Kelley (1984b). It derives from Kurt Lewin's emphasis on interdependence as “the essence of a group” (1948, p. 84), and it implements that view by borrowing payoff matrices from game theory (Luce & Raiffa, 1957) and adapting them to the broader purposes of an interpersonal psychology. Other, newer elaborations of the theory, concerning situational conditions affecting the timing and sequencing of behavior and the availability of information, are less well developed but deserve and receive attention in our Atlas.
The theory aspires to provide a means for drawing systematic and logical distinctions among situations which make it possible to imagine laying them out on a “map” or “globe” of the situational “world” – hence our metaphor of an “atlas.”