Epidemic trajectories and associated social responses vary widely between populations, with severe reactions sometimes observed. When confronted with fatal or novel pathogens, people exhibit a variety of behaviours from anxiety to hoarding of medical supplies, overwhelming medical infrastructure and rioting. We developed a coupled network approach to understanding and predicting social response. We couple the disease spread and panic spread processes and model them through local interactions between agents. The social contagion process depends on the prevalence of the disease, its perceived risk and a global media signal. We verify the model by analysing the spread of disease and social response during the 2009 H1N1 outbreak in Mexico City and 2003 severe acute respiratory syndrome and 2009 H1N1 outbreaks in Hong Kong, accurately predicting population-level behaviour. This kind of empirically validated model is critical to exploring strategies for public health intervention, increasing our ability to anticipate the response to infectious disease outbreaks.

Covered metallic endobronchial stents are increasingly used in the management of diverse large airway pathology and once deployed they are considered permanent. Long-term complications of stent fracture and airway granulation tissue formation may necessitate stent removal. We describe successful endoscopic removal of the Ultraflex expandable tracheal metallic stents (Microvasive; Boston Scientific, Natick, MA) in 5 patients at 105, 84, 50, 38, and 21 months after deployment, with excellent tracheal healing and clearance of granulation tissue noted at 6 weeks after removal in each patient.

Frequency‐of‐seeing curves were found to be a useful tool for the investigation of the variability inherently seen in the visual field results of glaucoma patients. The frequency‐of‐seeing curve is the fundamental function which describes the patient's response behaviour to liminal light stimuli. A number of previous researchers have used the frequency‐of‐seeing technique for measuring local variability (Chauhan and House, 1991; Weber and Rau, 1992; Olsson et al., 1992/93). This technique is used in preference to the index short‐term fluctuation, which has classically been used to measure variability in visual field results, as this index makes an assumption that variability is constant across the whole visual field.In this particular study, frequency‐of‐seeing curves were plotted at two different locations in the same eye of 15 established glaucoma patients. One location was relatively normal and the other glaucomatous. There was a significant difference in the appearance of the two curves; the normal location showed little variability, whereas the defective location showed a much larger degree of variability. One suggested reason for this increased variability in glaucoma patients has been that of poor fixation (Henson and Bryson, 1990/91).The frequency‐of‐seeing curve was used again to compare the variability of each location when the errors of fixation were removed. In those cases removing the errors of fixation did not have a significant effect on the variability of the frequency‐of‐seeing curve indicating that fixation errors were not a major cause of the variability seen in glaucoma patients.

BACKGROUND AND OBJECTIVES:We investigated outcomes in a UK neonatal cohort as a benchmark for care of children with sickle cell disease (SCD). DESIGN AND METHODS:Two-hundred and fifty-two children (180 with hemoglobin [Hb] SS, 64 with HbSC, and 8 with HbS/beta thalassemia), identified during 1983-2005 by universal birth screening in East London, were followed in a hospital and community-based program which included penicillin V prophylaxis from 3 months of age, 23-valent pneumococcal polysaccharide vaccine from 1993, conjugate pneumococcal vaccine from 2002 and transcranial Doppler screening from 1991. RESULTS:At the end of 2005, there were 2158 patient years of observation. The median age of the patients was 7.8 (interquartile range 3.3-13.0) years, and 2.8% of those enrolled had been lost to follow-up. The estimated survival of children with HbSS at 16 years was 99.0% (95% confidence interval, CI, 93.2 to 99.9%) and pneumococcal sepsis rate was 0.3 (95% CI 0.1-0.8) episodes per 100 patient-years. The risk of overt stroke was 4.3% (95%CI 1.5 to 11.4%) and could be further reduced by transcranial Doppler screening from infancy and transfusing all children with high-risk scans. No deaths, strokes or episodes of pneumococcal sepsis were observed in children with HbSC or HbS/beta thalassemia. The mortality rates from HbSS were significantly lower than those in other reported cohorts. INTERPRETATION AND CONCLUSIONS:Mortality in childhood SCD can virtually be eliminated in a well-resourced health service setting linking community-based care with a specialized, hospital-based center. SCD continues to cause substantial morbidity from acute complications and chronic organ damage. We recommend setting up of clinical networks to optimize the management of SCD.

Recent research indicates that there may be phenomenological, symptom, and diagnostic associations between trauma and hallucinations. However, the nature of the relationship is poorly understood from a psychological perspective. We report a theoretically informed phenomenological study. From descriptions of reported traumas and hallucinations, we assessed the rates of four types of hypothesized association between traumas and hallucinations (direct, indirect, stress, and none) in 75 participants with nonaffective psychosis. In a subgroup who had experienced trauma (N = 40), 12.5% had hallucinations with similar themes and content to their traumas, 45% had hallucinations in which the themes were the same but not the content, and 42.5% had no identifiable associations between their hallucinations and previously experienced trauma. Traumas rated as intrusive were significantly associated with hallucinations rated as intrusive, although intrusive hallucinations were not associated with traumas in general. The traumas most likely to be associated with hallucinations were sexual abuse and bullying.

International Journal of Geriatric PsychiatryVolume 19, Issue 8 p. 800-802 Research Letter The impact of NICE guidelines on the diagnosis and treatment of Alzheimer's disease among general medical hospital inpatients Ruth Cairns, Ruth Cairns Institute of Psychiatry, London, UKSearch for more papers by this authorJane Evans, Jane Evans King's College Hospital, London, UKSearch for more papers by this authorMartin Prince, Corresponding Author Martin Prince m.prince@iop.kcl.ac.uk Institute of Psychiatry, London, UKInstitute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.Search for more papers by this author Ruth Cairns, Ruth Cairns Institute of Psychiatry, London, UKSearch for more papers by this authorJane Evans, Jane Evans King's College Hospital, London, UKSearch for more papers by this authorMartin Prince, Corresponding Author Martin Prince m.prince@iop.kcl.ac.uk Institute of Psychiatry, London, UKInstitute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.Search for more papers by this author First published: 28 July 2004 https://doi.org/10.1002/gps.1160Citations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume19, Issue8August 2004Pages 800-802 RelatedInformation

Oropharyngeal candidiasis (OPC) is the most frequent opportunistic infection associated with HIV infection. Therapies such as topical clotrimazole and nystatin, as well as oral azoles, which had previously been effective prior to the advent of HIV, are increasingly only partially effective in OPC in HIV infection. The effectiveness of oral amphotericin B suspension for OPC is described in 17 HIV-infected patients whose response to other therapies had been unsatisfactory. Three patients yielded isolates of Candida albicans with a minimum inhibitory concentration (MIC) to fluconazole of >/=16 microg/mL. Eleven patients received amphotericin B suspension monotherapy. Of the 17 patients, the symptoms of six resolved entirely, seven patients partially responded, and four failed therapy. These data suggest that amphotericin B suspension may be a useful additional therapy for OPC in HIV-infected patients.

The views and attitudes towards the National Curriculum of a representative sample of primary school headteachers and infant class teachers of 5 to 6 year-olds were explored by means of a 14-item Likert scale approximately 1 year after its introduction into schools at Key Stage One. There was a wide spread of attitude scale scores amongst the teachers with no significant difference between the mean scores of the headteachers and class teachers. The teachers showed a very mixed pattern of responses to the individual items of the scale, expressing mainly favourable views on some and mainly unfavourable views on others, particularly regarding the likely effects on the primary curriculum of the introduction of the formal assessments of attainment targets. The teachers' views and attitudes were compared with those which they had expressed approximately 1 year previously, prior to the introduction of the National Curriculum into primary schools. A strong shift in the unfavourable direction was found between the two administrations of the scale, both in the teachers' scale total scores and in their responses to some of the individual items. The prediction that the experience of teaching the National Curriculum for a year would lead to a more favourable and less uncertain attitude towards it was not borne out.

The attitudes of a representative sample of primary school head teachers and infant class teachers of five to six year‐old children in an LEA in South Wales were explored by means of a 14 item Likert type scale administered just before the statutory implementation of the National Curriculum at Year One. Whilst there was a wide spread of attitude scale scores amongst the teachers their distribution was (non‐significantly) skewed in the positive direction. Analysis of the teachers’ responses to the individual items of the scale suggested that the majority of teachers were cautiously welcoming of the National Curriculum, whilst showing concern about the possibly negative effects of the introduction of formal assessment of attainment targets toward the end of this key stage. There was a trend, mainly non‐significant statistically, for the head teachers to express more positive views than their class teacher colleagues.

Three different respiratory manoeuvres, voluntary deep breaths (DB), lower thoracic expansion exercises (PT) and the use of an incentive spirometer (IS), were investigated for their immediate effects on transcutaneous oxygen (tc-pO2) and carbon dioxide (tc-pCO2) tensions. Twenty-four male patients whose condition was stable following coronary artery bypass graft surgery (CABG) were studied. A sample of arterial blood was taken from the patients to enable calibration of the transcutaneous electrodes. All respiratory manoeuvres produced small but significant rises in tc-pO2 which were of short duration, the increase with IS being significantly greater than that with either DB or PT (p<0.001). The associated falls in tc-pCO2 were less than 1 mmHg. Postoperative lung volumes and peak expiratory flow rate (PEFR) were significantly reduced as was the volume of air inspired during DB and PT (p<0.001). Despite patients' reports that it felt easier to take a deep breath when tactile stimulation (PT) was provided, there was no significant difference in inspired volume for DB and PT post-surgery. We conclude that tactile stimulation does not cause patients with a sternotomy incision to take a deeper breath than can be accomplished on their own. A transient improvement in ventilation-perfusion matching occurs as a result of the inspiratory manoeuvres studied, particularly with IS, and contributes to improved oxygenation.

Annals of the New York Academy of SciencesVolume 524, Issue 1 p. 369-378 Pharmacology and Physiology of Leukotrienes and Their Antagonistsa NEIL BARNES, NEIL BARNES London Chest Hospital, London, E2 9JX EnglandSearch for more papers by this authorJANE EVANS, JANE EVANS Department of Thoracic Medicine, Kings's College School of Medicine and Dentistry London, SE5 8RX EnglandSearch for more papers by this authorJERZY ZAKRZEWSKI, JERZY ZAKRZEWSKI Department of Thoracic Medicine, Kings's College School of Medicine and Dentistry London, SE5 8RX EnglandSearch for more papers by this authorPRISCILLA PIPER, PRISCILLA PIPER Department of Pharmacology, Hunterian Institute, Royal College of Surgeons of England, London, WC2A 3PN EnglandSearch for more papers by this authorJOHN COSTELLO, JOHN COSTELLO Department of Thoracic Medicine, Kings's College School of Medicine and Dentistry London, SE5 8RX EnglandSearch for more papers by this author NEIL BARNES, NEIL BARNES London Chest Hospital, London, E2 9JX EnglandSearch for more papers by this authorJANE EVANS, JANE EVANS Department of Thoracic Medicine, Kings's College School of Medicine and Dentistry London, SE5 8RX EnglandSearch for more papers by this authorJERZY ZAKRZEWSKI, JERZY ZAKRZEWSKI Department of Thoracic Medicine, Kings's College School of Medicine and Dentistry London, SE5 8RX EnglandSearch for more papers by this authorPRISCILLA PIPER, PRISCILLA PIPER Department of Pharmacology, Hunterian Institute, Royal College of Surgeons of England, London, WC2A 3PN EnglandSearch for more papers by this authorJOHN COSTELLO, JOHN COSTELLO Department of Thoracic Medicine, Kings's College School of Medicine and Dentistry London, SE5 8RX EnglandSearch for more papers by this author First published: April 1988 https://doi.org/10.1111/j.1749-6632.1988.tb38559.xCitations: 6 a This work was supported financially by the Joint Research Trust, King's College Hospital, and the Asthma Research Council. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume524, Issue1Biology of the LeukotrienesApril 1988Pages 369-378 RelatedInformation