The first use of Fulton's K for assessing and comparing the conditions of inter-tidal fish populations

Fulton's K condition factor was applied, for the first time, to inter-tidal specimens of the shanny (Lipophrys pholis) and long-spined scorpion fish (Taurulus bubalis) from two English rocky shore and two Welsh rocky shore sites during summer 2010 and winter 2011. As both species contribute to the diet of commercial species such as cod (Gadus morhua) and near-threatened species such as the European otter (Lutra lutra), their condition may affect that of these predators. Fulton's K found that inter-tidal Welsh fish maintained a ‘good’ condition between seasons, whereas the inter-tidal English fish were in a poorer condition during winter. Although condition also changed amongst the sites on each coast, further studies are needed into fish morphologies, environmental parameters, prey availabilities and abundances, and fish specimen sex and maturities

Final report: Member state and other donor approaches to good governance in development cooperation

This report presents an overview on approaches to governance-related issues and links with poverty reduction objectives of development cooperation among a sample of European Union (EU) Member States and other donors. The report forms part of a study commissioned by the European Community Poverty Reduction Effectiveness Programme (EC-PREP) to contribute to the definition of a consistent and common EU approach to governance related issues within the EC Directorate General Development (EC-DEV) initiative on Institutional Capacity Building. The Development Policy Coherence and Forward Studies unit within EC-DEV/B1 is coordinating this initiative. The report is divided into four main sections: Section 1: provides contextual information including study objectives, core good governance areas covered, study methodology and analytical framework used; Sections 2 & 3: provide summary profiles of both Member State and other donor approaches to good governance; Section 3: offers an analysis of emerging themes and issues arising from the donor profiles in line with the study objectives; Section 4: presents the study's main conclusions and recommendations

Enhance Warfighter Performance by Fostering Organizational Agility & Innovation in the Naval Research and Development Enterprise

NPS NRP Project PosterEnhance Warfighter Performance by Fostering Organizational Agility & Innovation in the Naval Research and Development EnterpriseASN (RDA) - Research, Development, and AcquisitionThis research is supported by funding from the Naval Postgraduate School, Naval Research Program (PE 0605853N/2098). https://nps.edu/nrpChief of Naval Operations (CNO)Approved for public release. Distribution is unlimited.

Enhance Warfighter Performance by Fostering Organizational Agility & Innovation in the Naval Research and Development Enterprise

NPS NRP Executive SummaryEnhance Warfighter Performance by Fostering Organizational Agility & Innovation in the Naval Research and Development EnterpriseASN (RDA) - Research, Development, and AcquisitionThis research is supported by funding from the Naval Postgraduate School, Naval Research Program (PE 0605853N/2098). https://nps.edu/nrpChief of Naval Operations (CNO)Approved for public release. Distribution is unlimited.

Inhaled methoxyflurane (Penthrox®) versus placebo for injury-associated analgesia in children - The MAGPIE trial (MEOF-002): Study protocol for a randomised controlled trial

BackgroundPain from injuries is one of the commonest symptoms in children attending emergency departments (EDs), and this is often inadequately treated in both the pre-hospital and ED settings, in part due to challenges of continual assessment and availability of easily administered analgesic options. Pain practices are therefore a key research priority, including within the field of paediatric emergency medicine. Methoxyflurane, delivered via a self-administered Penthrox® inhaler, belongs to the fluorinated hydrocarbon group of volatile anaesthetics and is unique among the group in having analgesic properties at low doses. Despite over 30 years of clinical acute analgesia use, and a large volume of evidence supporting its safety and efficacy, there is a paucity of randomised controlled trial data for Penthrox®.MethodsThis is an international multi-centre randomised, double-blind, placebo-controlled phase III trial assessing the efficacy and safety of methoxyflurane delivered via the Penthrox® inhaler for the management of moderate to severe acute traumatic pain in children and young people aged 6–17 years. Following written informed consent, eligible participants are randomised to self-administer either inhaled methoxyflurane (maximum dose of 2 × 3 ml) or normal saline placebo (maximum dose 2 × 5 ml). Patients, treating clinicians and research nurses are blinded to the treatment. The primary outcome is the change in pain intensity at 15 min after the commencement of treatment, as measured by the Visual Analogue Scale (VAS) or the Wong-Baker FACES® Pain Rating scale, with the latter converted to VAS values. Secondary outcome measures include the number and proportion of responders who achieve a 30% reduction in VAS score compared to baseline, rescue medication requested, time and number of inhalations to first pain relief, global medication performance assessment by the patient, clinician and research nurse, and evaluation of adverse events experienced during treatment and during the subsequent 14 ± 2 days. The primary analysis will be by intention to treat. The total sample size is 110 randomised and treated patients per treatment arm.DiscussionThe Methoxyflurane AnalGesia for Paediatric InjuriEs (MAGPIE) trial will provide efficacy and safety data for methoxyflurane administered via the Penthrox® inhaler, in children and adolescents who present to EDs with moderate to severe injury-related pain.Trial registrationEudraCT, 2016–004290-41. Registered on 11 April 2017.ClinicalTrials.gov, NCT03215056. Registered on 12 July 2017

Overexpression of specific CD44 isoforms is associated with aggressive cell features in acquired endocrine resistance

While endocrine therapy is the mainstay of ER+ breast cancer, the clinical effectiveness of these agents is limited by the phenomenon of acquired resistance that is associated with disease relapse and poor prognosis. Our previous studies revealed that acquired resistance is accompanied by a gain in cellular invasion and migration and also that CD44 family proteins are overexpressed in the resistant phenotype. Given the association of CD44 with tumor progression, we hypothesized that its overexpression may act to promote the aggressive behavior of endocrine-resistant breast cancers. Here, we have investigated further the role of two specific CD44 isoforms, CD44v3 and CD44v6, in the endocrine-resistant phenotype. Our data revealed that overexpression of CD44v6, but not CD44v3, in endocrine-sensitive MCF-7 cells resulted in a gain in EGFR signaling, enhanced their endogenous invasive capacity, and attenuated their response to endocrine treatment. Suppression of CD44v6 in endocrine-resistant cell models was associated with a reduction in their invasive capacity. Our data suggest that upregulation of CD44v6 in acquired resistant breast cancer may contribute to a gain in the aggressive phenotype of these cells and loss of endocrine response through transactivation of the EGFR pathway. Future therapeutic targeting of CD44v6 may prove to be an effective strategy alongside EGFR-targeted agents in delaying/preventing acquired resistance in breast cancer

The impact of experiences of ageism on sexual activity and interest in later life

Experiences of ageism are associated with poorer health outcomes. Sexual activity and interest are areas in life where the impact of ageism may also be evident as popular culture often depicts the older body as asexual, undesirable or sexually impotent. We explore the possible links between experiences of ageism and sexual activity/interest in later life using data from a study of Australians aged 60+. We explored characteristics of those who were more likely to have experienced ageism (measured using the Ageism survey) and the relationships between experiences of ageism and measures of sexual interest/activity in later life (n=1,817). Experiences of ageism were greater among those without a partner, unemployed participants, those with lower incomes, and poorer self-rated health. Adjusting for these differences, experiences of ageism were more likely to be reported by those who had not had sex in the past two years and were not sure about their hopes/plans for sex in the future. Those who reported their sexual interest had increased or decreased since 60 also reported greater levels of ageism experience, as did those who wanted to have sex more frequently in the future. Ageism appears to impact sexual activity and interest in different ways. It is critical that social policy aims to reverse attitudes that reinforce the view of the ageist asexual and unattractive older body or person

Survey of nurses’ knowledge and practice regarding medication administration using enteral tubes

© 2020 The Authors. Published by Wiley. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1111/jocn.15498Aim and objectives The aim was to identify the practice variation of the individual practitioners in medications’ formulation modification for patients using enteral feeding tubing; to support health practitioners involved in this process. Background Blockage of enteral tubes is a common problem that can sometimes be resolved but may require replacement of the tube. Medications are a common culprit. Design A survey of 73 registered nurses’ practices around medication administration via enteral feeding tubes. Methods A questionnaire study was undertaken within a district general hospital across a broad variety of wards to explore nurses’ experiences of medication administration via enteral tubes. The study is reported in accordance with the SQUIRE 2.0 guidelines from the EQUATOR network. Results Seventy‐three nurses responded. Twenty‐six percent reported never checking about drug modification for administration via a tube, 12% check every time and 61% when unsure about a new drug. The volume of fluid flushes administered after medication ranged from 7.5‐150mls. Seventy‐one percent of participants reported stopping feed when medications are required, varying from 1‐60 minutes. Sixty percent had experienced a blocked tube and 52% the tube being removed for these reasons. The clinical nurse specialist was the commonest first point of call to help. Staff named 15 medications as the most problematic to administer, lactulose and omeprazole were the top two. Conclusions Practice varies significantly amongst nurses around medication administration. Theoretically this may contribute to blocked tubes and excessive fluid administration to some patients. Barriers to medication administration were thematically grouped into: time, difficulty modifying medication, medication interactions and knowledge. Areas identified to support staff include training, devices to crush medications, medication suitability, multidisciplinary approach to streamline care and quick reference guides. Relevance to clinical practice Health professionals may use these results to reduce and ultimately avoid problems with administering medications through feeding tubes. Organisations may use these results to develop their local practice pathways for prescribing, dispensing and training around administration of medications through enteral tubes. In a community setting, this paper may improve the awareness of patients, caregivers and prescribers of the possible implications of tubing blockages

The MATISSE study: a randomised trial of group art therapy for people with schizophrenia.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: Art Therapy has been promoted as a means of helping people who may find it difficult to express themselves verbally engage in psychological treatment. Group Art Therapy has been widely used as an adjunctive treatment for people with schizophrenia but there have been few attempts to examine its effects and cost effectiveness has not been examined. The MATISSE study aims to evaluate the clinical and cost effectiveness of group Art Therapy for people with schizophrenia. METHOD/DESIGN: The MATISSE study is a three-arm, parallel group, pragmatic, randomised, controlled trial of referral to group Art Therapy plus standard care, referral to an attention control 'activity' group plus standard care, or standard care alone. Study participants were recruited from inpatient and community-based mental health and social care services at four centres in England and Northern Ireland. Participants were aged over 18 years with a clinical diagnosis of schizophrenia, confirmed by an examination of case notes using operationalised criteria. Participants were then randomised via an independent and remote telephone randomisation service using permuted stacked blocks, stratified by site. Art Therapy and activity groups were made available to participants once a week for up to 12 months. Outcome measures were assessed by researchers masked to allocation status at 12 and 24 months after randomisation. Participants and care givers were aware which arm of the trial participants were allocated to. The primary outcomes for the study are global functioning (measured using the Global Assessment of Functioning scale) and mental health symptoms (measured using the Positive and Negative Syndrome Scale) assessed at 24 months. Secondary outcomes were assessed at 12 and 24 months and comprise levels of group attendance, social function, satisfaction with care, mental wellbeing, and costs. DISCUSSION: We believe that this is the first large scale pragmatic trial of Art Therapy for people with schizophrenia. TRIAL REGISTRATION: Current Controlled Trials ISRCTN46150447.Published versio