The evidence-base for stroke education in care homes

<b>Summary.</b> <b>Research questions:</b> 1. What are registered care home nurses’ educational priorities regarding stroke care? 2. What are senior care home assistants’ educational priorities regarding stroke care? 3. How do care home nurses conceive stroke care will be delivered in 2010? <b>Study design:</b> This was a 2-year study using focus groups, stroke guidelines, professional recommendations and stroke literature for the development of a questionnaire survey for data collection. Workshops provided study feedback to participants. Data were collected in 2005–2006. <b>Study site:</b> Greater Glasgow NHS Health Board. <b>Population and sample:</b> A stratified random selection of 16 private, 3 voluntary and 6 NHS continuing care homes from which a sample of 115 trained nurses and 19 senior care assistants was drawn. <b>Results:</b> The overall response rate for care home nurses was 64.3% and for senior care assistants, 73.6%. Both care home nurses and senior care assistants preferred accredited stroke education. Care home nurses wanted more training in stroke assessment, rehabilitation and acute interventions whereas senior care assistants wanted more in managing depression, general stroke information and communicating with dysphasic residents. Senior care assistants needed more information on multidisciplinary team working while care home nurses were more concerned with ethical decision-making, accountability and goal setting. <b>Conclusions:</b> Care home staff need and want more stroke training. They are clear that stroke education should be to the benefit of their resident population. Guidelines on stroke care should be developed for care homes and these should incorporate support for continuing professional learning in relation to the resident who has had a stroke

Stroke education for healthcare professionals: making it fit for purpose

<b>Research questions:</b> 1. What are healthcare professionals’ (HCPs) educational priorities regarding stroke care? 2. Do stroke care priorities vary across the primary and secondary sectors? 3. How do HCPs conceive stroke care will be delivered in 2010? <b>Study design:</b> This was a two-year study using focus groups and interviews for instrument development, questionnaires for data collection and workshops to provide study feedback. Data were collected in 2005–06. <b>Study site:</b> One Scottish health board. <b>Inclusion criteria:</b> All National Health Service healthcare professionals working wherever stroke care occurred. <b>Population and sample:</b> Participants were drawn from 4 university teaching hospitals, 2 community hospitals, 1 geriatric medicine day hospital, 48 general practices (GPs), 12 care homes and 15 community teams. The sample comprised 155 doctors, 313 nurses, 133 therapists (physiotherapists, occupational therapists, speech and language therapists), and 29 ‘other HCPs’ (14 dieticians, 7 pharmacists, 2 podiatrists and 6 psychologists). <b>Results:</b> HCPs prefer face-to-face, accredited education but blended approaches are required that accommodate uni- and multidisciplinary demands. Doctors and nurses are more inclined towards discipline-specific training compared to therapists and other healthcare professionals (HCPs). HCPs in primary care and stroke units want more information on the social impact of stroke while those working in stroke units in particular are concerned with leadership in the multidisciplinary team. Nurses are the most interested in teaching patients and carers. <b>Conclusions</b> Stroke requires more specialist stroke staff, the upskilling of current staff and a national education pathway given that stroke care is most effectively managed by specialists with specific clinical skills. The current government push towards a flexible workforce is welcome but should be educationally-sound and recognise the career aspirations of healthcare professionals

Investor Sentiment And Close-End Country Funds?

An innovative method to estimate the duration of investor sentiment is applied to closed-end country fund returns and it finds that U.S. investor sentiment has a short life.  The effects of sentiment on closed-end country fund returns are largely consistent with existing literature however, it is only apparent in daily time-series regressions.  Sentiment rapidly fades at a weekly frequency and virtually disappears using monthly return observations.  These results suggest that the kind of investor sentiment for country fund prices does not have a persistent component

The Non-Commutative Cycle Lemma

We present a non-commutative version of the cycle lemma of Dvoretsky and Motzkin that applies to free groups and use this result to solve a number of problems involving cyclic reduction in the free group. We also describe an application to random matrices, in particular the fluctuations of Kesten's Law.Comment: 13 pages, minor corrections and improvement

Masses of ground and excited-state hadrons

We present the first Dyson-Schwinger equation calculation of the light hadron spectrum that simultaneously correlates the masses of meson and baryon ground- and excited-states within a single framework. At the core of our analysis is a symmetry-preserving treatment of a vector-vector contact interaction. In comparison with relevant quantities the root-mean-square-relative-error/degree-of freedom is 13%. Notable amongst our results is agreement between the computed baryon masses and the bare masses employed in modern dynamical coupled-channels models of pion-nucleon reactions. Our analysis provides insight into numerous aspects of baryon structure; e.g., relationships between the nucleon and Delta masses and those of the dressed-quark and diquark correlations they contain.Comment: 25 pages, 7 figures, 4 table

Why are flare ribbons associated with the spines of magnetic null points generically elongated?

Coronal magnetic null points exist in abundance as demonstrated by extrapolations of the coronal field, and have been inferred to be important for a broad range of energetic events. These null points and their associated separatrix and spine field lines represent discontinuities of the field line mapping, making them preferential locations for reconnection. This field line mapping also exhibits strong gradients adjacent to the separatrix (fan) and spine field lines, that can be analysed using the `squashing factor', $Q$. In this paper we make a detailed analysis of the distribution of $Q$ in the presence of magnetic nulls. While $Q$ is formally infinite on both the spine and fan of the null, the decay of $Q$ away from these structures is shown in general to depend strongly on the null-point structure. For the generic case of a non-radially-symmetric null, $Q$ decays most slowly away from the spine/fan in the direction in which $|{\bf B}|$ increases most slowly. In particular, this demonstrates that the extended, elliptical high-$Q$ halo around the spine footpoints observed by Masson et al. (Astrophys. J., 700, 559, 2009) is a generic feature. This extension of the $Q$ halos around the spine/fan footpoints is important for diagnosing the regions of the photosphere that are magnetically connected to any current layer that forms at the null. In light of this, we discuss how our results can be used to interpret the geometry of observed flare ribbons in `circular ribbon flares', in which typically a coronal null is implicated. We conclude that both the physics in the vicinity of the null and how this is related to the extension of $Q$ away from the spine/fan can be used in tandem to understand observational signatures of reconnection at coronal null points.Comment: Pre-print version of article accepted for publication in Solar Physic