An experimental COVID-19 messaging study in a representative sample of the Scottish population: Increasing physical distancing intentions through self-efficacy

Objectives

Self-efficacy is important for adherence to transmission-reducing behaviours (e.g., physical distancing) as also shown in the CHARIS project. We aimed to show that a theory-based short message can increase physical distancing self-efficacy and intentions to keep physical distance.

Design

Structured telephone surveys with a randomly selected nationally representative sample of adults in Scotland (N = 497).

Methods

Participants were randomly assigned to one of two experimental conditions: message condition (short message to increase self-efficacy via vicarious experiences, verbal persuasion and emotional arousal) or control condition (no message). Followed by measures for self-efficacy and intention for physical distancing on 4-point scales. Adherence to physical distancing was assessed on a 5-point frequency scale (never – always).

Results

Using mediation analyses with bootstrapping procedures, we first confirmed that self-efficacy was associated indirectly with adherence, via higher intentions in a partial mediation (unstandardized indirect effect .21, 95% CI .18–.25). The message increased self-efficacy; participants receiving the message reported higher self-efficacy (M = 4.23, SD = .80) compared to participants in the control condition (M = 4.08, SD = .77; standardized regression coefficient = .19, p < .05) and self-efficacy affected intention (.48, p < .001). There was a small significant indirect effect of the message on intention via self-efficacy (unstandardized indirect effect .07, CI .01–.14).

Conclusions

Increasing self-efficacy for physical distancing with a short message can successfully increase intention to physical distance via increased self-efficacy. As both self-efficacy and intentions are important predictors of adherence to transmission-reducing behaviours short messages have potential to limit the spread of COVID-19.     

Forecasting drug utilization and expenditure in a metropolitan health region

Background  

New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning), forecasting of drug utilization and expenditure, critical drug evaluation as well as structured programs for the introduction and follow-up of new drugs. The aim of this paper is to present the forecasting model and the predicted growth in all therapeutic areas in 2010 and 2011.     

Young adolescents' independent mobility,related factors and association with transport to school. A cross-sectional study

Background  

Children's independent mobility differs between groups of adolescents, but knowledge is lacking on how mobility-limiting factors interact. This study explores the association between factors that can affect young adolescents' mobility, searching for typical patterns within a geographical area where mobility is both relatively high and promoted (in this case Stockholm County, Sweden). An additional question is how clusters of limiting factors and demographic attributes relate to active commuting to school.     

Maternal hyperglycemia and adverse pregnancy outcomes in Dar es Salaam,Tanzania

Objective

To evaluate maternal glucose levels during pregnancy as a predictor of adverse perinatal outcomes in Dar es Salaam, Tanzania.

Methods

Random blood glucose measurements were analyzed from 3383 pregnant women enrolled in a randomized trial to assess the impact of multivitamins on pregnancy outcomes in Dar es Salaam between August 2001 and July 2004. Information on maternal and neonatal morbidity was recorded at monthly study visits, delivery, and 6 weeks postpartum. Binomial regression and generalized estimating equations were used to determine the relationship between elevated glucose (> 7.8 mmol/L) and pregnancy outcomes.

Results

In total, 25 women had elevated glucose (0.7%). Hyperglycemia was associated with an increased risk of delivery before 37 weeks [relative risk (RR), 2.11; 95% confidence interval [CI], 1.07–4.13; P = 0.03), delivery before 34 weeks (RR, 4.15; 95% CI, 1.43–12.03, P = 0.009), incident gestational hypertension (RR, 2.90; 95% CI, 1.24–6.76; P = 0.01), low birth weight (RR, 2.87; 95% CI, 1.18–6.99; P = 0.02), reduced newborn head circumference (mean difference, –1.57; 95% CI, –2.51 to − 0.62; P = 0.001), and fetal loss (RR, 3.38; 95% CI, 1.13–10.08; P = 0.03).

Conclusion

Maternal hyperglycemia is uncommon among pregnant Tanzanian women, but nonetheless seems to increase the risk of several adverse perinatal outcomes.     

A murine model of accelerated periodontal disease in diabetes

Diabetes is a risk factor for periodontal disease in humans. In hyperglycemia, glycoxidation of proteins and lipids results in the formation of advanced glycation endproducts, or AGEs. The accumulation of AGEs in the plasma and tissues, and their interaction with their cellular receptor for AGE (RAGE), has been implicated in diabetic complications. In order to establish a model with which to delineate the specific host response factors that underlie the development of periodontal disease in diabetes, male C57BL/6J mice were rendered diabetic with streptozotocin. One month after documentation of diabetes or control state, mice were inoculated with the human periodontal pathogen Porphyromonas gingivalis, strain 381 (P. gingivalis) or treated with vehicle. Infection with P. gingivalis was achieved, as demonstrated by infiltration of gingival tissue with granulocytes, presence of DNA specific for P. gingivalis as well as increased serum antibody titer to P. gingivalis. At 2 and 3 months after infection, increased alveolar bone loss was demonstrated in P. gingivalis–inoculated diabetic vs. non–diabetic mice, along with enhanced tissue–destructive capacity, as demonstrated by increased collagenolytic activity in gingival extracts. Consistent with an important role for AGE–RAGE interaction, increased AGE deposition and expression of vascular and monocyte RAGE were demonstrated in diabetic gingiva compared with non–diabetic controls. Taken together, these data indicate that we have established a murine model of enhanced periodontal disease in diabetes. This model will serve to delineate molecular mechanisms which account for the increased susceptibility of diabetic patients to periodontal disease.     

EMMPRIN/CD147 is an independent prognostic biomarker in cutaneous melanoma

CD147 has been implicated in melanoma invasion and metastasis mainly through increasing metalloproteinase synthesis and regulating VEGF/VEGFR signalling. In this study, the prognostic value of CD147 expression was investigated in a cohort of 196 cutaneous melanomas including 136 consecutive primary malignant melanomas, 30 lymph nodes, 16 in‐transit and 14 visceral metastases. A series of 10 normal skin, 10 blue nevi and 10 dermal nevi was used as control. CD147 expression was assessed by immunohistochemistry, and the association of its expression with the clinicopathological characteristics of patients and survival was evaluated using univariate and multivariate statistical analyses. Univariate analysis showed that high CD147 expression was significantly associated with metastatic potential and with a reduced overall survival (P < 0.05 for both) in primary melanoma patients. CD147 expression level was correlated with histological factors which were associated with prognosis: Clark level, ulceration status and more particularly with Breslow index (r = 0.7, P < 10^?8). Multivariate analysis retained CD147 expression level and ulceration status as predicting factors for metastasis and overall survival (P < 0.05 for both). CD147 emerges as an important factor in the aggressive behaviour of melanoma and deserves further evaluation as an independent prognostic biomarker.     

Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction

Ischemia of the areas supplied by the anterior cerebral artery is relatively uncommon. In addition, combined hemiballismus and masturbation have rarely been reported in patients with cerebrovascular disease. We describe herein a 62-year-old right-handed man simultaneously exhibiting right side hemiballismus and involuntary masturbation with the left hand after bilateral infarction of the anterior cerebral artery territory. Right side hemiballismus was related to the disruption of afferent fibers from the left frontal lobe to the left subthalamic nucleus. Involuntary masturbation using the left hand was exclusively linked to a callosal type of alien hand syndrome secondary to infarction of the right side of the anterior corpus callosum. After 2 weeks, these abnormal behaviours were completely extinguished. This report stresses the wide diversity of clinical manifestations observed after infarction of the anterior cerebral artery territory.     

Exocytosis ofToxoplasma gondii dense granules into the parasitophorous vacuole after host cell invasion

Tachyzoites ofToxoplasma gondii have been shown to exocytose the contents of dense granules into the parasitophorous vacuole after host cell invasion. A monoclonal antibody specific for a 27-kDa protein was used to locate the dense granules by immunoelectron microscopy. The same antibody also reacted with the tubular network found in the parasitophorous vacuole, which confirmed that the dense granules were exocytosed by tachyzoites.     

Quantitative study of apoptosis in normal rat gastroduodenal mucosa

The occurrence of apoptosis in the normal gastrointestinal mucosa has been given little consideration until now, although the phenomenon may be of interest in the light of recent hypotheses about its role in physiological cell renewal. In the present study, a quantitative evaluation conducted on normal gastric and duodenal mucosa of young rats has shown that apoptosis is a rare but constant phenomenon: 1.4 +/- 1.1 (mean +/- 1 s.d.) apoptotic bodies were observed within the surface epithelium of single gastric pits and 3 +/- 1 in duodenal villi. In both situations, the apoptosis showed a preferential localization in the juxtaluminal segments of the epithelium. This phenomenon appears distinct from passive exfoliation of mucosal cells and, as an expression of 'programmed cell death', it is likely to contribute to the normal intestinal epithelial cell turnover.