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Health outcomes 3 months and 6 months after molnupiravir treatment for COVID-19 for people at higher risk in the community (PANORAMIC): a randomised controlled trial
Get PDFBackgroundNo randomised controlled trials have yet reported on the effectiveness of molnupiravir on longer term outcomes for COVID-19. The PANORAMIC trial found molnupiravir reduced time to recovery in acute COVID-19 over 28 days. We aimed to report the effect of molnupiravir treatment for COVID-19 on wellbeing, severe and persistent symptoms, new infections, health care and social service use, medication use, and time off work at 3 months and 6 months post-randomisation.MethodsThis study is a follow-up to the main analysis, which was based on the first 28 days of follow-up and has been previously reported. For this multicentre, primary care, open-label, multi-arm, prospective randomised controlled trial conducted in the UK, participants were eligible if aged at least 50 years, or at least 18 years with a comorbidity, and unwell 5 days or less with confirmed COVID-19 in the community. Participants were randomly assigned to the usual care group or molnupiravir group plus usual care (800 mg twice a day for 5 days), which was stratified by age (0·99; number needed to treat [NNT] 62·5; 6 months: –1·9% [–2·9% to –0·9%]; p(sup)>0·99, NNT 52·6) or persistent symptoms (3 months: adjusted risk difference –2·1% [–2·9% to –1·5%]; p(sup)>0·99; NNT 47·6; 6 months: –2·5% [–3·3% to –1·6%]; p(sup)>0·99; NNT 40) were reduced in severity, and health-related quality of life (measured by the EQ-5D-5L) improved in the molnupiravir plus usual care group at 3 months and 6 months (3 months: adjusted mean difference 1·08 [0·65 to 1·53]; p(sup)>0·99; 6 months: 1·09 [0·63 to 1·55]; p(sup)>0·99). Ratings of wellness (3 months: adjusted mean difference 0·15 (0·11 to 0·19); p(sup)>0·99; 6 months: 0·12 (0·07 to 0·16); p(sup)>0·99), experiencing any more severe symptom (3 months; adjusted risk difference –1·6% [–2·6% to –0·6%]; p(sup)=0·99; 6 months: –1·9% [–2·9% to –0·9%]; p(sup)>0·99), and health-care use (3 months: adjusted risk difference –1·4% [–2·3% to –0·4%]; p(sup)>0·99; NNT 71·4; 6 months: –0·5% [–1·5% to 0·4%]; p(sup)>0·99; NNT 200) had high probabilities of superiority with molnupiravir treatment. There were significant differences in persistence of any symptom (910 [8·9%] of 10 190 vs 1027 [11%] of 9332, NNT 67) at 6 months, and reported time off work at 3 months (2017 [17·9%] of 11 274 vs 2385 [22·4%] of 10 628) and 6 months (460 [4·4%] of 10 562 vs 527 [5·4%] of 9846; NNT 100). There were no differences in hospitalisations at long-term follow-up.InterpretationIn a vaccinated population, people treated with molnupiravir for acute COVID-19 felt better, experienced fewer and less severe COVID-19 associated symptoms, accessed health care less often, and took less time off work at 6 months. However, the absolute differences in this open-label design are small with high numbers needed to treat
How Do Autistic Students Do in the Eyes of Their Peers? Non-Autistic Judgments About the Academic Experiences of Autistic and Non-Autistic University Students, Based on Brief Samples of Behavior
Get PDFBackground: Previous research has found that people can make a variety of judgments about others based on brief samples of their behavior such as judging their social favorability and whether they wish to socialize with them. Non-autistic people frequently perceive autistic people more negatively than non-autistic people, although we do not fully understand the real-world consequences of this perceptual bias. This study extends previous work by investigating these perceptual biases within a real-world context: university.Method: Non-autistic university students (n = 25) watched short, candid video clips of autistic and non-autistic people. Participants rated different aspects of the stimulus model’s academic experience, focusing on their motivation to study, academic success, grades, and happiness at university.Results: Across all measures, non-autistic participants judged the academic experience of autistic models more negatively than non-autistic models, perceiving lower academic motivation, success, grades, and happiness at university.Conclusion: These results demonstrate a consistent negative bias that autistic students may face from their peers at university. We discuss the importance of these results in terms of autism stigma and the potential consequences for improving inclusivity at university
Philosophy with Refugees and Sanctuary Seekers
Get PDFThis paper outlines a teaching initiative designed to introduce philosophy to sanctuary seekers and refugees. Despite facing challenges such as scheduling conflicts and inconsistent attendance, the program demonstrated success. Participants displayed a notable comfort with the student-centred pedagogy, exhibited trust in their fellow students, and expressed a willingness to share their perspectives. Additionally, the program shed light on a distinct conception of education and assessment within the sanctuary seeker and refugee community. One notable, and perhaps surprising, insight from our study is that there is no compelling rationale to believe that the study of philosophy provides a greater 2 benefit to sanctuary seekers and refugees compared to any other group. However, it is abundantly clear that it does indeed yield positive results
The Memory in Return Volatility: An Analysis of Mutual Fund Returns
No full textThis paper examines long memory in the return volatility in the cross-section of U.S. mutual funds. Our results provide evidence of this phenomenon. Through univariate analysis, we find that the long memory in mutual fund return volatility is more pronounced than in stock return volatility. Additionally, the long memory estimate is negatively related to expected fund returns. Holding a long position in shorter-term memory funds and a short position in longer-term memory funds generates significant excess returns of 0.26% per month for value-weighted portfolios
Cell division cycle 6 is an independent prognostic biomarker in breast cancer
Get PDFCell division cycle 6 (CDC6) is a cell cycle protein involved in cell cycle control, DNA replication and cancer cell apoptosis. This study investigated the prognostic value of CDC6 in breast cancer (BC) utilising large well-characterised cohorts of early-stage BC. CDC6 messenger RNA (mRNA) was assessed using the Molecular Taxonomy of the Breast Cancer International Consortium (n=1980), the Cancer Genome Atlas (n=854) and Kaplan–Meier plotter (n=4,929) cohorts. CDC6 protein expression was evaluated using immunohistochemistry in a large (n=951) well-characterised Nottingham BC cohort. The associations between CDC6, clinicopathological parameters, molecular features and patient outcomes were assessed. High CDC6 expression positively correlated with dysregulation of key BC-related genes, including gene involved in cell cycle, DNA damage repair, epithelial cell migration, and tumour microenvironment control, as well as with markers characteristic of the basal-like phenotype (CK5, CK14 and CK17). High CDC6 mRNA and protein expression were associated with clinicopathological parameters characteristic of aggressive behaviour, including high tumour grade, large tumour size, the presence of lymphovascular invasion and hormone receptor negativity. High CDC6 protein expression was an independent predictor of poor outcome [p=0.007; hazard ratio (HR)=1.3; 95% confidence interval (CI) 1.2–1.9). This study indicates that CDC6 is an independent prognostic biomarker in BC. These results warrant further functional validation for CDC6 as a potential therapeutic target in BC
Tourist Film Souvenirs and Post-Postmodern Authentication
Get PDFIdentified and analyzed in this article are tourist film souvenirs. Associated with the Rickshaw Run adventure tourism experience, these travel artifacts are crafted from video fragments gathered on the road, combined into an organized overall, and shared online. Films are found to structure tourists’ self-imaginings during and post-travel. Filmmaking enables protagonists to roleplay as extraordinary travelers, to selectively assemble clips representing themselves as such, and to solicit external attention thereupon. Agglomerating and asserting tourist fantasies as reality, films prop, produce, and publicize authenticity claims relating to protagonists as extraordinary. Contributing to recent discussions of post-postmodern authenticity, illustrated is how this reconstructive orientation manifests in tourism authentication practices-priorities. Noted are infusions of fantasy into tourism experience, as facilitated by film souvenirs. Considered are practitioner implications of authentication processes that are highly self-centric. Rearrangements of tourists and toured, as captured in films reviewed, highlight opportunities and challenges around enabling tourists’ fantastical self-imaginings
The manifestations of universality and cultural specificity in national curriculum policy frameworks: negotiations for culturally reflective practice in early childhood education
Get PDFThis paper presents findings from a review of 19 national curriculum policy frameworks (NCPFs) across the globe and discusses dominant and culturally specific discourses that shape early childhood education (ECE). We combine two frameworks of developmental universality and specificity and culturally contextualised pedagogy to explore whether and how NCPFs are venues where culturally reflective practice is negotiated. Culturally reflective practice embraces minimum, globally universal standards of children’s rights and evidence-based practice, meanwhile critically reflects on the dominance of global and local discourses that impede a glocalised interpretation of quality in ECE. The paper argues that culturally reflective policy and practice is an alternative framework to cultural appropriateness/relevance in ECE
How Institutional Logics Inform Emotional Labour: An Ethnography of Junior Doctors
Get PDFSociological analysis of emotional labour can be aided by considering how institutional logics inform the performance of emotional labour. We consider the link between institutional logics and emotional labour by conducting an in-depth case study of junior doctors in a large UK hospital. We point to three key institutional logics – bureaucratic, consumerist and professional logics – and show how they inform the emotional labour of junior doctors. We also consider how doctors respond to these logics through enactment processes of choice, resistance and negotiation. In this way, we make an important theoretical contribution by identifying the way that institutional logics relate to the performance of emotional labour. We also make an important empirical contribution by contributing to a growing body of ethnographies on the emotional labour of doctors
Organizations offering line manager training in mental health and presenteeism: A secondary data analysis of organizational-level data
Get PDFPresenteeism (working while ill) due to mental ill-health is estimated to be one of the largest economic costs to employers. We seek to investigate the relationship between line manager training in mental health (MH) and presenteeism trends at work. The aim of this study was twofold: (i) to examine the relationship between the provision of a new and emerging workplace MH and wellbeing (MH&WB) initiative - line manager (LM) training in MH - and presenteeism as reported by organisations, and (ii) to examine the reasons for presenteeism, and organisational-level strategies used to action it. To address these questions, we conducted a secondary data analysis using panel data from 7139 firms in England over four time points (2020-2023). Probit regression analysis revealed that organisations offering LM training are less likely to report presenteeism. Our analysis revealed that providing LM training may increase awareness and readiness to tackle presenteeism within the organisation, but this does not always translate into actionable strategies. Limitations of the study and recommendations for future research are discussed
The use of the term Black, Asian and Minority Ethnic in The Voice and Eastern Eye newspapers, a discourse analysis of Covid news stories in the UK press
Get PDFThis study finds that during the pandemic the UK mainstream press presented a blame narrative in their news stories when discussing BAME communities in relation to Covid-19. Articles from The Voice and Eastern Eye newspapers aimed at diasporic readers were contrasted with stories from UK mainstream press, published during the first lockdown in the UK. An intersectional approach was taken to examine news articles published between March and July 2020. The analysis revealed a failure in the British mainstream press to recognise structural and systemic racism when reporting Covid related stories. In contrast, the ethnic press looked for solutions and tried to examine structural racism. A deficit approach is evident in the mainstream press that sought to apportion blame to cultures, faith, and customs. There is a focus on the terminology BAME (Black Asian and minority ethnic) used as a formal descriptor by the UK Government and media to describe minority communities. The term is now defunct. It is acknowledged that Covid-19 accentuated differences that already existed in society, particularly those pertaining to race. Research has also evidenced that mainstream news organisations can be overly critical of minority communities, conflating their perceived flaws and condemning minorities as a method to delegitimise claims of mistreatment or differential outcomes
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