Development and evaluation of tools and an intervention to improve patient- and carer-centred outcomes in Longer-Term Stroke care and exploration of adjustment post stroke: the LoTS care research programme

Background: Evidence-based care pathways are required to support stroke patients and their carers in the longer term. Aims: The twofold aim of this programme of four interlinking projects was to enhance the care of stroke survivors and their carers in the first year after stroke and gain insights into the process of adjustment. Methods and results: We updated and further refined a purposely developed system of care (project 1) predicated on a patient-centred structured assessment designed to address areas of importance to patients and carers. The structured assessment is linked to evidence-based treatment algorithms, which we updated using a structured protocol: reviewing available guidelines, Cochrane reviews and randomised trials. A pragmatic cluster randomised controlled trial evaluation of the clinical effectiveness and cost-effectiveness of this system of care was undertaken in 29 community-based UK stroke care co-ordinator services (project 2). In total, 15 services provided the system of care and 14 continued with usual practice. The primary objective was to determine whether the intervention improved patient psychological outcomes (General Health Questionnaire-12) at 6 months; secondary objectives included functional outcomes for patients, outcomes for carers and cost-effectiveness, as measured through self-completed postal questionnaires at 6 and 12 months. A total of 800 patients and 208 carers were recruited; numbers of participants and their baseline characteristics were well balanced between intervention and control services. There was no evidence of statistically significant differences in primary or secondary end points or adverse events between the two groups, nor evidence of cost-effectiveness. Intervention compliance was high, indicating that this is an appropriate approach to implement evidence into clinical practice. A 22-item Longer-term Unmet Needs after Stroke (LUNS) questionnaire was developed and robustly tested (project 3). A pack including the LUNS questionnaire and outcome assessments of mood and social activity was posted to participants 3 or 6 months after stroke to assess acceptability and validity. The LUNS questionnaire was re-sent 1 week after return of the first pack to assess test–retest reliability. In total, 850 patients were recruited and the acceptability, validity and test–retest reliability of the LUNS questionnaire as a screening tool for post-stroke unmet need were confirmed. This tool is now available for clinical use. An in-depth qualitative investigation was undertaken with 22 patients (and carers) at least 1 year after stroke (project 4) to gain further insights into the experience of adjustment. This included initial semistructured interviews, limited observations and solicited diaries with a follow-up interview 3–4 months after the initial interview and highlighted a range of different trajectories for post-stroke recovery. Conclusions: The programme has been completed as planned, including one of the largest ever stroke rehabilitation trials. This work highlights that successfully addressing the needs of a heterogeneous post-stroke population remains problematic. Future work could explore stratifying patients and targeting services towards patients (and carers) with specific needs, leading to a more specialised bespoke service. The newly developed LUNS questionnaire and the qualitative work will help inform such services

A global blended tropopause based on ERA data, Part I: Climatology

A new tropopause definition, based on a flow-dependent blending of the traditional thermal tropopause with one based on potential vorticity, has been developed. The benefits of such a blending algorithm are most apparent in regions with synoptic scale fluctuations between tropical and extratropical airmasses. The properties of the local airmass determine the relative contributions to the location of the blended tropopause, rather than this being determined by a specified function of latitude. Global climatologies of tropopause height, temperature, potential temperature and zonal wind, based on European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis (ERA) ERA-Interim data, are presented for the period 1989-2007. Features of the seasonal-mean tropopause are discussed on a global scale, alongside a focus on selected monthly climatologies for the two high latitude regions and the tropical belt. The height differences between climatologies based on ERA-Interim and ERA-40 data are also presented. Key spatial and temporal features seen in earlier climatologies, based mainly on the World Meteorological Organization thermal tropopause definition, are reproduced with the new definition. Tropopause temperatures are consistent with those from earlier climatologies, despite some differences in height in the extratropics

The WiggleZ Dark Energy Survey: Survey Design and First Data Release

The WiggleZ Dark Energy Survey is a survey of 240,000 emission line galaxies in the distant universe, measured with the AAOmega spectrograph on the 3.9-m Anglo-Australian Telescope (AAT). The target galaxies are selected using ultraviolet photometry from the GALEX satellite, with a flux limit of NUV<22.8 mag. The redshift range containing 90% of the galaxies is 0.2<z<1.0. The primary aim of the survey is to precisely measure the scale of baryon acoustic oscillations (BAO) imprinted on the spatial distribution of these galaxies at look-back times of 4-8 Gyrs. Detailed forecasts indicate the survey will measure the BAO scale to better than 2% and the tangential and radial acoustic wave scales to approximately 3% and 5%, respectively. This paper provides a detailed description of the survey and its design, as well as the spectroscopic observations, data reduction, and redshift measurement techniques employed. It also presents an analysis of the properties of the target galaxies, including emission line diagnostics which show that they are mostly extreme starburst galaxies, and Hubble Space Telescope images, which show they contain a high fraction of interacting or distorted systems. In conjunction with this paper, we make a public data release of data for the first 100,000 galaxies measured for the project.Comment: Accepted by MNRAS; this has some figures in low resolution format. Full resolution PDF version (7MB) available at http://www.physics.uq.edu.au/people/mjd/pub/wigglez1.pdf The WiggleZ home page is at http://wigglez.swin.edu.au

Processes of Participation in the Development of Urban Food Strategies: A Comparative Assessment of Exeter and Eindhoven

Urban food strategies are increasingly being used as means to address a multitude of challenges presented by food system failings. The use of participatory approaches has become common practice in the field of urban food systems planning. These approaches are believed to democratize, legitimize and increase effectiveness of addressing challenges. Despite these “promises”, they have also been viewed as problematic for being unbalanced and lacking accountability. This paper sets out to compare the creation and use of new participatory spaces in two initiatives in two European cities in their on-going attempts to formulate urban food strategies through multi-actor processes. This is explored through operationalisation of two key concepts essential to participatory approaches: participation and accountability. As such, the paper addresses how participatory processes for urban food strategies can be conceptualised when policy making involves the interplay of actors, knowledges and spaces. We conclude that within the two cases, ample attention is given to get a cross-section of the types of participants involved, while accountability is an aspect still under-represented. Based on the two cases, we argue that incorporation of accountability in particular will be instrumental in the development and implementation of more mature urban food strategies. However, it is essential for participatory processes to not completely break from more “traditional” policy processes, at risk of limiting progress in strategy development and deploymen

Carlisle Memorial Volume

Table of Contents: The Carlisle Family Life Sketch of Dr. Carlisle - by Dr. Charles Forster Smith Dr. Carlisle as a Citizen - by Watson B. Duncan The Wofford Chapel Hour - by Dr. Henry Nelson Snyder Wofford College and its President Twenty Years Ago - by Dr. Robert A. Law Dr. Carlisle as a Teacher - by Dr. David Duncan Wallace Tributes to Dr. Carlislehttps://digitalcommons.wofford.edu/collegebooks/1005/thumbnail.jp

Automatic phonological activation during visual word recognition in bilingual children:a cross-language masked priming study in Grades 3 and 5

International audienc

Investigation of a transgenic model of Alzheimer's disease, the TASTPM mouse, using magnetic resonance spectroscopy and matrix assisted laser desorption imaging

There is currently no definitive biomarker for Alzheimer's Disease (AD), confirmation of diagnosis is only possible post-mortem. Magnetic resonance spectroscopy (MRS) has potential in aiding diagnosis, an MRS scan can be performed during an MRI scan, only adding around 10 minutes to scan time. Use of data from the two scans may allow more accurate diagnosis of AD. This thesis investigates a transgenic mouse model of AD, the TASTPM mouse, using in vitro and in vivo MRS as well as matrix assisted laser desorption ionisation mass spectrometry imaging (MALDI MS Imaging). The first aim of the study was to search for a biomarker of AD that may allow better diagnosis or further our understanding of the pathology of the disease. The second aim was to evaluate the TASTPM mouse as a model of AD for use in preclinical testing of amyloid lowering agents. The third aim was to investigate a thalamic pathology in the TASTPM mice using MALDI MS Imaging. Metabolically, we found differences between the brains of TASTPM mice and their wild type base strain in both in vitro and in vivo scans. These differences may be exploited in the preclinical testing of novel amyloid lowering therapies. We also found similarities with human AD and other mouse models, lower N-acetylaspartate, lower glutamate and higher myo-inositol are all observed in human AD, as well as the TASTPM mice in vivo. We also found further evidence of impaired neuronal energy metabolism in TASTPM mice, such as lower succinate. Cerebral hypometabolism is a symptom of human AD. The TASTPM mouse seems to be a fairly good approximation of the human disease, sharing several traits. In our investigation of the thalamic pathology, we discovered a peptide which was strongly localised to the regions of the pathology and isolated it, but were unable to identify it, the work in this area will continue.EThOS - Electronic Theses Online ServiceGlaxoSmithKlineGBUnited Kingdo

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Radiation-induced neuroinflammation:a potential protective role for poly(ADP-ribose) polymerase inhibitors?

Radiotherapy (RT) plays a fundamental role in the treatment of glioblastoma (GBM). GBM are notoriously invasive and harbor a subpopulation of cells with stem-like features which exhibit upregulation of the DNA damage response (DDR) and are radioresistant. High radiation doses are therefore delivered to large brain volumes and are known to extend survival but also cause delayed toxicity with 50%–90% of patients developing neurocognitive dysfunction. Emerging evidence identifies neuroinflammation as a critical mediator of the adverse effects of RT on cognitive function. In addition to its well-established role in promoting repair of radiation-induced DNA damage, activation of poly(ADP-ribose) polymerase (PARP) can exacerbate neuroinflammation by promoting secretion of inflammatory mediators. Therefore, PARP represents an intriguing mechanistic link between radiation-induced activation of the DDR and subsequent neuroinflammation. PARP inhibitors (PARPi) have emerged as promising new agents for GBM when given in combination with RT, with multiple preclinical studies demonstrating radiosensitizing effects and at least 3 compounds being evaluated in clinical trials. We propose that concomitant use of PARPi could reduce radiation-induced neuroinflammation and reduce the severity of radiation-induced cognitive dysfunction while at the same time improving tumor control by enhancing radiosensitivity