Access to and use of clinical services and disease-modifying therapies by people with progressive multiple sclerosis in the United Kingdom

Background: According to current UK guidelines everyone with progressive MS should have access to an MS Specialist but levels of access and use of clinical services is unknown. Our objective was to investigate access to MS Specialists, use of clinical services and disease-modifying therapies (DMTs) by people with progressive MS in the United Kingdom. Methods: A UK wide, online survey was conducted via the UK MS Register. Inclusion criteria: age over 18 years, primary or secondary progressive MS and a member of the UK MS Register. Participants were asked about access to MS Specialists; recent clinical service use; receipt of regular review and current and previous DMT use. Participant demographics; quality of life and disease impact measures were supplied from the UK MS Register. Results: In total 1298 participants responded: 5% were currently taking DMT; 23% had previously taken DMT; and 95% reported access to an MS Specialist. Most utilised services were: MS Doctor/Nurse (50%), General Practitioner (45%), and Physiotherapist (40%). Seventy-four percent received a regular review although 37% received theirs less than annually. Current DMT use was associated with better quality of life but past DMT use was associated with poorer quality of life and higher impact of disease. Conclusions: Access to, and use of, MS Specialists was high. However a gap in service provision was highlighted in both receiving and frequency of regular reviews

Inflammation-induced effector CD4+ T cell interstitial migration is alpha-v integrin dependent

Leukocytes must traverse inflamed tissues to effectively control local infection. Although motility in dense tissues appears to be integrin-independent actin-myosin based, during inflammation changes to the extracellular matrix (ECM) may necessitate distinct motility requirements. Indeed, we found that T cell interstitial motility was critically dependent on RGD-binding integrins in the inflamed dermis. Inflammation-induced deposition of fibronectin was functionally linked to increased αv integrin expression on effector CD4+ T cells. Using intravital multi-photon imaging, we found that CD4+ T cell motility was dependent on αv expression. Selective αv blockade or knockdown arrested TH1 motility in the inflamed tissue and attenuated local effector function. These data show a context-dependent specificity of lymphocyte movement in inflamed tissues that is essential for protective immunity

Mapping Mazes: Developing a Taxonomy to Investigate Mazes in Children’s Stories

Pausing, repeating, revising, and abandoning words and phrases are common characteristics of speech called mazes. Mazes affect the fluency of speech and are thought be related to language ability and language processes. Few relationships between mazes and language ability and language processes have been identified. This is due to methodological differences in how researchers have coded mazes and approached elicitation tasks. The main purpose of this study was to address these methodological challenges by developing a reliable and objective maze taxonomy. Once developed, the maze taxonomy was applied to the stories of Kindergarten and Grade Two students. Stories were elicited from oral and picture tasks to determine age or task effects on maze production. Overall, the Kindergarten and Grade Two students produced mazes at similar rates and used more mazes in stories elicited from oral tasks than picture tasks

Thrust Table for Measuring High-Power Model Rocket Engines

As the field of astronautical engineering continues to grow, the demand for workers having experience with thrust analysis and rocketry grows as well. The goal of this project is to design and manufacture a thrust table to be used in future projects involving high-power model rockets. The thrust table is designed using a rail system with extruded aluminum and aluminum base plate, and electronics based on Arduino to measure thrust and chamber pressure in the rocket engine. The data collected is then used in a Matlab model to predict the flight of the rocket. Initial testing shows the table returns reliable thrust measurement, but further testing is needed to improve measurements of chamber pressure. The next step in this project is to use the table to test nozzle properties’ effects in the thrust of the motors, and to optimize those properties for maximum thrust and efficiency

History and trends of professional nursing

365 p.; 22 cm