Cold water strawberry disease (CWSD), or red mark syndrome (RMS), is a severe dermatitis affecting the rainbow trout Oncorynchus mykiss. The condition, which presents as multifocal, raised lesions on the flanks of affected fish, was first diagnosed in Scotland in 2003 and has since spread to England and Wales. Results of field investigations indicated the condition had an infectious aetiology, with outbreaks in England linked to movements of live fish from affected sites in Scotland. Transmission trials confirmed these results, with 11 of 149 and 106 of 159 naïve rainbow trout displaying CWSD-characteristic lesions 104 to 106 d after being cohabited with CWSD-affected fish from 2 farms (Farm B from England and Farm C from Wales, respectively). The condition apparently has a long latency, with the first characteristic lesions in the previously naïve fish not definitively observed until 65 d (650 day-degrees) post-contact with affected fish. Affected fish from both outbreak investigations and the infection trial were examined for the presence of viruses, oomycetes, parasites and bacteria using a combination of techniques and methodologies (including culture-independent cloning of PCR-amplified bacterial 16S rRNA genes from lesions), with no potentially causative infectious agent consistently identified. The majority of the cloned phylotypes from both lesion and negative control skin samples were assigned to Acidovorax-like β-Proteobacteria and Methylobacterium-like α-Proteobacteria. KEY WORDS: RFLP · 16S rRNA · Clone library · Flavobacterium psychrophilum · Red mark syndromeResale or republication not permitted without written consent of the publisher Dis Aquat Org 79: 207-218, 2008 report that the disease is prevalent at low water temperatures (<15°C), in comparison to the UK experience of WWSD, which generally occurs only when water temperatures exceed 14°C (a summer rather than winter condition). Early signs of CWSD can include severe scale loss prior to the emergence of the characteristic external lesions (Ferguson et al. 2006), and there are no signs of systemic infection (i.e. no affect on appetite, growth or mortality). However, the condition causes losses to farmers both in treatment costs and in downgrading of affected fish at harvest.The objective of the present study was to determine if the disease had an infectious aetiology by conducting a disease investigation on farms affected by the condition. Laboratory trials evaluating whether the condition could be transmitted from affected to naïve fish were also conducted. As a recent report implicated Flavobacterium psychrophilum as potentially being linked to the condition (Ferguson et al. 2006), particular effort was made to identify whether this, or a closely related organism, was associated with diseased fish. MATERIALS AND METHODS Outbreak investigationsOutbreaks of CWSD at 3 farms in England and Wales were investigated between January 2005 and January 2006. Structured interviews with the farmers asked about the chronology of the disease o...

In research, participatory approaches involve engaging in the research with people and empower co-researchers to have a voice. The aim of this review was to synthesize the methods and approaches used to enable children, adolescents, and families to be involved in a participatory approach in research conducted to inform development of health resources and interventions aimed at children and adolescents. Key databases were searched systematically using key word and subject heading searches and included studies were appraised for both methodological quality and sufficiency of reporting of their participatory approach. Findings were synthesized using a critical narrative approach. Among 26 eligible studies, commonly reported participatory approaches involved community-based participatory research, codesign, participatory design, coproduction, and user-centred design. A need was identified to involve co-researchers more in the later stages of participatory approaches. Most studies were of low to moderate methodological quality. A wide variety of methods and activities were used in the studies to enable children to participate in the research, but few studies provided sufficient evidence of their participatory approach. This review concludes that reporting of participatory approaches might benefit from the guidelines that acknowledge the dual nature of participatory approaches as both a research method and an approach that enables action and change.

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AimsAsthma is the commonest chronic condition of childhood with 1 in 11 UK children currently on treatment.1 When properly maintained the asthmatic child can usually lead a normal life, whereas poorly controlled asthma can lead to reduced quality of life, morbidity and mortality, resulting in 25,073 UK paediatric hospital admissions in 2011–12.2 Guidelines facilitating management, aimed at reducing these complications are frequently updated but are not immune to lack of adherence and compliance. In this audit, we focussed on community data which can assist targeting patients at high risk of complications.MethodsWe reviewed all 126 paediatric asthma cases at an urban GP practice. We recorded the percentage of prescribed corticosteroid inhalers collected as a measure of inadherence, number of overdue months of annual review as a measure of noncompliance, and emergency care attendances for asthma as a measure of complication risk, between 01/01/2014–01/01/2015.Abstract G357(P) Figure 1Variation in adherence, compliance and complications with delay in annual reviewAbstract G357(P) Figure 2ResultsThere was no significant difference in adherence for children who attended routine review up to 5 months from due time compared to those attending six to eleven months overdue (74% vs 68%). The latter group was significantly more likely to require emergency care (OD=4, CI=1.29–12.40, p < 0.025) but was also at significantly higher risk to require emergency care than children who attended review over 12 months overdue (OD = 4.33, CI=1.40–13.42, p < 0.025), despite higher rate of inhaler collection (68% vs 50%, OD=4 (CI=1.4–13.4, p < 0.025).ConclusionDespite a high and similar compliance rate, children with low annual review adherence are at significantly higher risk for complications. These results reinforce the usefulness of current guidelines and the importance of annual review for patient education and medication titration. Interestingly the subgroup with the lowest compliance and adherence was not at increased complication risk. This may be due to imprecise diagnosis, milder disease, or overmedication; future investigation of this group can assist in correct resource allocation.Finally our results suggest the importance of targeting those who require treatment (as expressed by inhalers uptake), yet substantially delay the annual review.References accessed 02/15/15 accessed 02/12/15