Developing influenza and respiratory syncytial virus activity thresholds for syndromic surveillance in England.

Influenza and respiratory syncytial virus (RSV) are common causes of respiratory tract infections and place a burden on health services each winter. Systems to describe the timing and intensity of such activity will improve the public health response and deployment of interventions to these pressures. Here we develop early warning and activity intensity thresholds for monitoring influenza and RSV using two novel data sources: general practitioner out-of-hours consultations (GP OOH) and telehealth calls (NHS 111). Moving Epidemic Method (MEM) thresholds were developed for winter 2017-2018. The NHS 111 cold/flu threshold was breached several weeks in advance of other systems. The NHS 111 RSV epidemic threshold was breached in week 41, in advance of RSV laboratory reporting. Combining the use of MEM thresholds with daily monitoring of NHS 111 and GP OOH syndromic surveillance systems provides the potential to alert to threshold breaches in real-time. An advantage of using thresholds across different health systems is the ability to capture a range of healthcare-seeking behaviour, which may reflect differences in disease severity. This study also provides a quantifiable measure of seasonal RSV activity, which contributes to our understanding of RSV activity in advance of the potential introduction of new RSV vaccines.

Retrospective Observational Study of Atypical Winter Respiratory Illness Season Using Real-Time Syndromic Surveillance, England, 2014-15.

During winter 2014-15, England experienced severe strains on acute health services. We investigated whether syndromic surveillance could contribute to understanding of the unusually high level of healthcare needs. We compared trends for several respiratory syndromic indicators from that winter to historical baselines. Cumulative and mean incidence rates were compared by winter and age group. All-age influenza-like illness was at expected levels; however, severe asthma and pneumonia levels were above those expected. Across several respiratory indicators, cumulative incidence rates during 2014-15 were similar to those of previous years, but higher for older persons; we saw increased rates of acute respiratory disease, including influenza like illness, severe asthma, and pneumonia, in the 65-74- and >75-year age groups. Age group-specific statistical algorithms may provide insights into the burden on health services and improve early warning in future winters.

Why decision making may not require awareness.

Newell & Shanks (N&S) argue against the idea that any significant role for unconscious influences on decision making has been established by research to date. Inasmuch as this conclusion applies to the idea of an "intelligent cognitive unconscious," we would agree. Our concern is that the article could lead the unwary to conclude that there are no unconscious influences on decision making - and never could be. We give reasons why this may not be the case.

Modeling human sequence learning under incidental conditions.

This research explored the role that associative learning may play in human sequence learning. Two-choice serial reaction time tasks were performed under incidental conditions using 2 different sequences. In both cases, an experimental group was trained on 4 subsequences: LLL, LRL, RLR, and RRR for Group "Same" and LLR, LRR, RLL, and RRL for Group "Different," with left and right counterbalanced across participants. To control for sequential effects, we assayed sequence learning by comparing their performance with that of a control group, which had been trained on a pseudorandom ordering, during a test phase in which both experimental and control groups experienced the same subsequences. Participants in both groups showed sequence learning, but the group trained on "different" learned more and more rapidly. This result is the opposite that predicted by the augmented simple recurrent network used by F. W. Jones and I. P. L. McLaren (2009, Human sequence learning under incidental and intentional conditions, Journal of Experimental Psychology: Animal Behavior Processes, Vol. 35, pp. 538-553), but can be modeled using a reparameterized version of this network that also includes a more realistic representation of the stimulus array, suggesting that the latter may be a better model of human sequence learning under incidental conditions.

Causes of binocular legal blindness in an australian metropolitan community.

Australian legal blindness is defined as bilateral corrected visual acuity less than 6/60; if visual acuity is better than this, collateral visual impairments may be included. Persons thus affected qualify for the Invalid Pension (Blindness). From October 1975 to June 1982, I studied clinical data of 311 persons assessed as legally blind, and recorded diagnoses. I personally examined 259 of these persons and a medical colleague examined 52. Examinees were resident in Brisbane (or environs), Australia. Eleven persons had asymmetrical conditions (analysed separately), and 300 had symmetrical conditions. Causes of the latter were genetically transmissible (20.3%), adult maculopathy (18%), congenital (12.7%), vascular (non-diabetic) (8.7%), adult glaucoma (8.3%), diabetes (7.3%), trauma (6%), and others (18.7%). Of 61 symmetrical genetic cases causes were retinitis pigmentosa (34.4%), congenital cataracts (16.4%), retinal dystrophy and maculopathy (13.1%), Leber's optic atrophy (9.8%), and others (26.3%). These results suggest that more attention should be directed to genetic counselling.