Improving the development, monitoring and reporting of stroke rehabilitation research: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable (SRRR)

Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations the group reviewed all stroke rehabilitation trials published in 2015 (n=182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention calls into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence based clinical care we urge the research community to endorse and adopt our recommendations

City of Buffalo Comprehensive Plan 2018-2038

The City of Buffalo Comprehensive Plan 2038 focuses on factors of growth and development including: public participation, development considerations, transportation, economic development, housing, and community facilities. The plan includes a Future Land Use Map, which increases development opportunities and indicates preferred or suitable land use for the city.The City of Buffalo Comprehensive Plan 2038 provides a guide for the future growth of the city. This document was developed by Texas Target Communities in partnership with the City of Buffalo. The document was developed through collaboration with Texas Target Communities (TTC) and a City Advisory Committee representing the City of Buffalo. The purpose of the collaboration was to assess current community conditions, develop goals, objectives, and implementation strategies related to future development & growth strategies, through a public participatory process, in order to help guide the future growth of the City

City of Buffalo Comprehensive Plan 2018-2038

The City of Buffalo Comprehensive Plan 2038 focuses on factors of growth and development including: public participation, development considerations, transportation, economic development, housing, and community facilities. The plan includes a Future Land Use Map, which increases development opportunities and indicates preferred or suitable land use for the city.The City of Buffalo Comprehensive Plan 2038 provides a guide for the future growth of the city. This document was developed by Texas Target Communities in partnership with the City of Buffalo. The document was developed through collaboration with Texas Target Communities (TTC) and a City Advisory Committee representing the City of Buffalo. The purpose of the collaboration was to assess current community conditions, develop goals, objectives, and implementation strategies related to future development & growth strategies, through a public participatory process, in order to help guide the future growth of the City

City of Hitchcock Comprehensive Plan 2020-2040

Hitchcock is a small town located in Galveston County (Figure 1.1), nestled up on the Texas Gulf Coast. It lies about 40 miles south-east of Houston. The boundaries of the city encloses an area of land of 60.46 sq. miles, an area of water of 31.64 sq. miles at an elevation just 16 feet above sea level. Hitchcock has more undeveloped land (~90% of total area) than the county combined. Its strategic location gives it a driving force of opportunities in the Houston-Galveston Region.The guiding principles for this planning process were Hitchcock’s vision statement and its corresponding goals, which were crafted by the task force. The goals focus on factors of growth and development including public participation, development considerations, transportation, community facilities, economic development, parks, and housing and social vulnerabilityTexas Target Communitie

The conservation status of the world’s reptiles

MB and MR were funded by a grant from the Esmee Fairbairn Foundation, BC by the Rufford Foundation. North American and Mexican species assessments were funded by the Regina Bauer Frankenberg Foundation for Animal Welfare. Species assessments under the Global Reptile Assessment (GRA) initiative are supported by: Moore Family Foundation, Gordon and Betty Moore Foundation, Conservation International, Critical Ecosystem Partnership Fund (CEPF), and European Commission. Additional acknowledgements are included in the online supplementary material. The assessment workshop for Mexican reptiles was kindly hosted by Ricardo Ayala and the station personnel of the Estacion de Biologia Chamela, Institut de Biologia, Universidad Nacional Autonoma de Mexico. Workshop and logistical organisation of the Philippines assessments was provided by the Conservation International Philippines Office, in particular Ruth Grace Rose Ambal, Melizar V. Duya and Oliver Coroza. Workshop and logistical organisation for the European Reptile and Amphibian Assessments was provided by Doga Dernegi, in particular Ozge Balkiz and Ozgur Koc. Workshop and logistical organisation for assessments of sea snakes and homalopsids was provided by the International Sea Turtle Symposium and Dr. Colin Limpus (Australian Government Environmental Protection Agency). Special thanks to Jenny Chapman (EPA) and Chloe Schaub le (ISTS). Thank you also to Dr. Gordon Guymer (Chief Botanist Director of Herbarium) for accommodating us at the Herbarium in the Brisbane Botanical Gardens, and Mark Read and Kirsten Dobbs (Great Barrier Reef Marine Parks Association) and Dave Pollard and Brad Warren (Ocean Watch Australia) for institutional support. Mohamed Bin Zayed Species Conservation Fund, Conservation International Madagascar and the Darwin Initiative contributed to funding the costs of the Madagascar reptile workshop.Effective and targeted conservation action requires detailed information about species, their distribution, systematics and ecology as well as the distribution of threat processes which affect them. Knowledge of reptilian diversity remains surprisingly disparate, and innovative means of gaining rapid insight into the status of reptiles are needed in order to highlight urgent conservation cases and inform environmental policy with appropriate biodiversity information in a timely manner. We present the first ever global analysis of extinction risk in reptiles, based on a random representative sample of 1500 species (16% of all currently known species). To our knowledge, our results provide the first analysis of the global conservation status and distribution patterns of reptiles and the threats affecting them, highlighting conservation priorities and knowledge gaps which need to be addressed urgently to ensure the continued survival of the world’s reptiles. Nearly one in five reptilian species are threatened with extinction, with another one in five species classed as Data Deficient. The proportion of threatened reptile species is highest in freshwater environments, tropical regions and on oceanic islands, while data deficiency was highest in tropical areas, such as Central Africa and Southeast Asia, and among fossorial reptiles. Our results emphasise the need for research attention to be focussed on tropical areas which are experiencing the most dramatic rates of habitat loss, on fossorial reptiles for which there is a chronic lack of data, and on certain taxa such as snakes for which extinction risk may currently be underestimated due to lack of population information. Conservation actions specifically need to mitigate the effects of human-induced habitat loss and harvesting, which are the predominant threats to reptiles.Esmee Fairbairn FoundationRufford FoundationRegina Bauer Frankenberg Foundation for Animal WelfareMoore Family FoundationGordon and Betty Moore FoundationConservation International, Critical Ecosystem Partnership Fund (CEPF)European Commission Joint Research CentreZayed Species Conservation FundConservation International MadagascarDarwin Initiativ

City of Ivanhoe Comprehensive Plan 2018-2038

the City of Ivanhoe is located in Tyler County, which is in southeastern Texas near the Louisiana border. The land is gently rolling, with an elevation ranging from 100 to 400 feet above sea level. Texas Target Communities developed this document in partnership with the City of Ivanhoe. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies. The project aimed to enhance community-wide discussion through a public participatory process, resulting in developing a comprehensive plan to help guide the future growth of the County and City. A representative task force of community members engaged in a participatory planning process, including visioning, goal setting, alternative scenario exploration, and strategies for implementation. Using courses on campus, TAMU urban planning students were exposed to the planning process and explored innovative ideas. The result of this collaboration is this document, which provides strategies for the community’s growth utilizing the natural resource and the assets of the City.The Ivanhoe Comprehensive Plan 2017-2037 provides guidance for the future development of the city. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies., which resulted in this comprehensive plan document.Texas Target Communitie

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke