scores were significantly associated with 12-month changes in EQ-5D-3L index scores in both groups (β = - 0.73,

 < 0.001 and β = - 0.40,

 = 0.003, respectively).

Patients with RA in persistent MDAS experience substantial ongoing physical disability, poor QoL, and pain. HAQ-DI is an important predictor of future disability and reduced QoL, supporting current national recommendations to measure HAQ-DI in routine care.

Patients with RA in persistent MDAS experience substantial ongoing physical disability, poor QoL, and pain. HAQ-DI is an important predictor of future disability and reduced QoL, supporting current national recommendations to measure HAQ-DI in routine care.Background Environmental sustainability is the driver for finding the optimal bioremediation cocktail with the combination of highly potent hydrocarbonoclastic strains and the nutrient additives that significantly enhance mineralization of crude oil in polluted soil in order to mitigate its deleterious effects on the environment. selleckchem In this study, four hydrocarbon-degrading bacterial strains were pre-selected from mined rhizobacterial isolates in aged crude oil-contaminated soil. Method Agrowaste residues of poultry-droppings, corn chaff, and plantain peel were selected among others for their ability to support high biomass of selected bacterial strains. Baseline proximate analysis was performed on the agrowaste residues. Simplified, one variable at a time (OVAT) was employed in the validation of the variables for optimization using the Multivariate analysis tool of Response Surface Methodology (RSM). To test the significant formulation variables, the Box-Behnken approach using 15 runs design was adopted. Results The rate of contaminant removal was observed to fit into a quadratic function. For optimal rate or contaminant removal, the fitted model predicted the optimal formulation cocktail condition to be within 0.54 mg/kg (Corn steep liquor), phosphate 137.49 mg/kg (poultry droppings) and 6.4% inocula for initial TPH of 9744 mg kg -1 and THC of 9641 mg kg -1 contaminant level. The model for the application of the bioremediation product and the variables evaluated had a significant p-value less then 0.005 for the attainment of 85 to 96 % of TPH and THC removal after 56 days of treatment. Conclusions This study has shown the need to harness the abundant agrowaste nutrients in supporting high throughput rhizobacteria in the formulation of a bioremediation agent suitable for use in the reclamation of oil spill sites in the Niger Delta oil-producing region.[This retracts the article DOI 10.1093/jncics/pkz003.].Social distancing measures introduced in response to the COVID-19 pandemic resulted in an almost complete cessation of family bedside interaction, with negative effects on patients, families and staff. Here we report on measures introduced in response to this situation at the critical care unit in one hospital involving the use of videoconferencing technology. The solutions used also had the potential to be extended to clinical use, for example when seeking advice for colleagues, and to the provision of training.Integration of primary and secondary care for the management of respiratory disease is a long-held ambition. Here, we describe how respiratory specialists at a large NHS trust, working with primary care clinicians in the area, set up a GP hotline and respiratory support service in response to the COVID-19 pandemic, with the aim of enhancing delivery of care to patients in this unprecedented time. Working across traditional organisational boundaries in this way confers benefits to patients and clinicians, illustrating the value of new, integrated models of care.Service redevelopment has taken place across the NHS in response to the COVID-19 pandemic. At North Bristol NHS Trust, six vulnerable medical staff in non-patient facing roles set up a virtual advice service called ‘Ask the Medical Reg’. This service aimed to provide senior medical support to inpatient and community teams for general medical and COVID-19-related queries. Here we outline the structure of our service and present data from the first 4 weeks of operation. We describe how the service has supported both junior doctors working within the hospital and GPs and paramedics, helping with complex decisions to prevent unnecessary admissions.A 7-day consultant-geriatrician-led service across five surgical wards, with integrated working among surgeons and physicians, was implemented in response to the COVID-19 pandemic. Our model has shown to increase discharge rates and improve MDT wellbeing. Embedded physician working with surgeons could be key in the recovery to COVID-19.The coronavirus disease 2019 (COVID-19) pandemic has led to multiple service delivery changes across acute care sectors in the UK. Due to increased responsibility for care of COVID-19 patients, medical trainees across all specialties might experience difficulty in achieving certain competencies for their training curriculum due to changes in learning opportunities. While there might be a tendency to perceive these changes negatively in terms of the impact on training, we think this unprecedented situation might present a unique learning opportunity. A group of geriatric medicine trainees and trainers devised an innovative, forward-thinking specific training plan based on existing Joint Royal Colleges of Physicians Training Board geriatric medicine curricula, encouraging development of a personal development plan (PDP) tailored to the pandemic. This model could be considered for all specialty training curricula, providing a proactive approach to optimising training during the pandemic. By formulating a ‘pandemic PDP’ early and considering methods to maximise learning, training needs can be met even in these extraordinary times.COVID-19 has created unprecedented challenges for healthcare services internationally. Many NHS organisations have cancelled outpatient clinics to release frontline clinical staff and minimise risk of patients contracting COVID-19. While many outpatient services manage chronic diseases, a number of services manage high-acuity patients. Delivery of these acute outpatient services during the pandemic has posed particular challenges and required significant service model reconfiguration. The acute diabetes foot clinic is an important example of such a service. We explore the important lessons learnt during the COVID-19 pandemic for managing high-acuity outpatient services through the context of the diabetic foot clinic. Learning can be divided into the following categories remote and digital working, physical changes in service delivery, workforce challenges and post-pandemic preparedness. This learning is applicable to a wide range of high-acuity services during and following the pandemic. It is particularly relevant as we expand outpatient care provision to avoid hospital admissions.