Hope in People With Aphasia

Background: Hope is considered to be important for health, recovery, and rehabilitation outcomes in a range of healthcare populations. Little is known about hope in people following stroke, and even less is known about hope in people with aphasia following stroke as they are commonly excluded from research in this field. Aims: This study aimed to explore how hope was experienced by people with aphasia following stroke during the post-acute period of rehabilitation, and to identify factors influencing the experience of hope. Methods & Procedures: This study utilised an Interpretive Description methodology. Data were collected through semi-structured interviews with five people with aphasia. Supported conversation techniques were used to facilitate full contribution of participants. Data were analysed using a number of approaches—coding, thematic analysis, narrative construction, diagramming, and memoing. Outcomes & Results: Hope was experienced in two ways. Simply ‘having’ hope was a broad but passive sense of hope which appeared to be the primary, constant form of hope. Actively hoping was an active, future-oriented form of hope that was experienced intermittently by participants. The experience of hope appeared dynamic and complex and seemingly influenced by three primary factors: uncertainty about the future; viewing hope as double-sided; and a sense of disruption. These were in turn influenced by a person's past experiences, present reality and perceived future. Conclusions: Hope is considered important by people with aphasia. It appears related to how people engage in rehabilitation and may be influenced by clinicians. As such, it is a concept that therapists should be aware of. Suggestions for how clinicians may consider and address hope are provided and discussed

Noise Levels In An Urban Asian School Environment

Background noise is known to adversely affect speech perception and speech recognition. High levels of background noise in school classrooms may affect student learning, especially for those pupils who are learning in a second language. The current study aimed to determine the noise level and teacher speech-to-noise ratio (SNR) in Hong Kong classrooms. Noise level was measured in 146 occupied classrooms in 37 schools, including kindergartens, primary schools, secondary schools and special schools, in Hong Kong. The mean noise levels in occupied kindergarten, primary school, secondary school and special school classrooms all exceeded recommended maximum noise levels, and noise reduction measures were seldom used in classrooms. The measured SNRs were not optimal and could have adverse implications for student learning and teachers’ vocal health. Schools in urban Asian environments are advised to consider noise reduction measures in classrooms to better comply with recommended maximum noise levels for classrooms.published_or_final_versio

Crystal structure of a quinoenzyme: copper amine oxidase of Escherichia coli at 2 å resolution

AbstractBackground: Copper amine oxidases are a ubiquitous and novel group of quinoenzymes that catalyze the oxidative deamination of primary amines to the corresponding aldehydes, with concomitant reduction of molecular oxygen to hydrogen peroxide. The enzymes are dimers of identical 70–90 kDa subunits, each of which contains a single copper ion and a covalently bound cofactor formed by the post-translational modification of a tyrosine side chain to 2,4,5-trihydroxyphenylalanine quinone (TPQ).Results The crystal structure of amine oxidase from Escherichia coli has been determined in both an active and an inactive form. The only structural differences are in the active site, where differences in copper coordination geometry and in the position and interactions of the redox cofactor, TPQ, are observed. Each subunit of the mushroom-shaped dimer comprises four domains: a 440 amino acid C-terminal β sandwich domain, which contains the active site and provides the dimer interface, and three smaller peripheral α/β domains (D1–D3), each of about 100 amino acids. D2 and D3 show remarkable structural and sequence similarity to each other and are conserved throughout the quinoenzyme family. In contrast, D1 is absent from some amine oxidases. The active sites are well buried from solvent and lie some 35 å apart, connected by a pair of β hairpin arms.Conclusion The crystal structure of E. coli copper amine oxidase reveals a number of unexpected features and provides a basis for investigating the intriguing similarities and differences in catalytic mechanism of members of this enzyme family. In addition to the three conserved histidines that bind the copper, our studies identify a number of other conserved residues close to the active site, including a candidate for the catalytic base and a fourth conserved histidine which is involved in an interesting intersubunit interaction

The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE) : study protocol for a randomized controlled trial

Peer reviewedPublisher PD

A ‘quiet revolution’? The impact of Training Schools on initial teacher training partnerships

This paper discusses the impact on initial teacher training of a new policy initiative in England: the introduction of Training Schools. First, the Training School project is set in context by exploring the evolution of a partnership approach to initial teacher training in England. Ways in which Training Schools represent a break with established practice are considered together with their implications for the dominant mode of partnership led by higher education institutions (HEIs). The capacity of Training Schools to achieve their own policy objectives is examined, especially their efficacy as a strategy for managing innovation and the dissemination of innovation. The paper ends by focusing on a particular Training School project which has adopted an unusual approach to its work and enquires whether this alternative approach could offer a more profitable way forward. During the course of the paper, five different models of partnership are considered: collaborative, complementary, HEI-led, school-led and partnership within a partnership

Use of low-dose oral theophylline as an adjunct to inhaled corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with high morbidity, mortality, and health-care costs. An incomplete response to the anti-inflammatory effects of inhaled corticosteroids is present in COPD. Preclinical work indicates that 'low dose' theophylline improves steroid responsiveness. The Theophylline With Inhaled Corticosteroids (TWICS) trial investigates whether the addition of 'low dose' theophylline to inhaled corticosteroids has clinical and cost-effective benefits in COPD. METHOD/DESIGN: TWICS is a randomised double-blind placebo-controlled trial conducted in primary and secondary care sites in the UK. The inclusion criteria are the following: an established predominant respiratory diagnosis of COPD (post-bronchodilator forced expiratory volume in first second/forced vital capacity [FEV1/FVC] of less than 0.7), age of at least 40 years, smoking history of at least 10 pack-years, current inhaled corticosteroid use, and history of at least two exacerbations requiring treatment with antibiotics or oral corticosteroids in the previous year. A computerised randomisation system will stratify 1424 participants by region and recruitment setting (primary and secondary) and then randomly assign with equal probability to intervention or control arms. Participants will receive either 'low dose' theophylline (Uniphyllin MR 200 mg tablets) or placebo for 52 weeks. Dosing is based on pharmacokinetic modelling to achieve a steady-state serum theophylline of 1-5 mg/l. A dose of theophylline MR 200 mg once daily (or placebo once daily) will be taken by participants who do not smoke or participants who smoke but have an ideal body weight (IBW) of not more than 60 kg. A dose of theophylline MR 200 mg twice daily (or placebo twice daily) will be taken by participants who smoke and have an IBW of more than 60 kg. Participants will be reviewed at recruitment and after 6 and 12 months. The primary outcome is the total number of participant-reported COPD exacerbations requiring oral corticosteroids or antibiotics during the 52-week treatment period. DISCUSSION: The demonstration that 'low dose' theophylline increases the efficacy of inhaled corticosteroids in COPD by reducing the incidence of exacerbations is relevant not only to patients and clinicians but also to health-care providers, both in the UK and globally. TRIAL REGISTRATION: Current Controlled Trials ISRCTN27066620 was registered on Sept. 19, 2013, and the first subject was randomly assigned on Feb. 6, 2014

Use of technology in children's dietary assessment

Background: Information on dietary intake provides some of the most valuable insights for mounting intervention programmes for the prevention of chronic diseases. With the growing concern about adolescent overweight, the need to accurately measure diet becomes imperative. Assessment among adolescents is problematic as this group has irregular eating patterns and they have less enthusiasm for recording food intake. Subjects/Methods: We used qualitative and quantitative techniques among adolescents to assess their preferences for dietary assessment methods.Results: Dietary assessment methods using technology, for example, a personal digital assistant (PDA) or a disposable camera, were preferred over the pen and paper food record. Conclusions: There was a strong preference for using methods that incorporate technology such as capturing images of food. This suggests that for adolescents, dietary methods that incorporate technology may improve cooperation and accuracy. Current computing technology includes higher resolution images, improved memory capacity and faster processors that allow small mobile devices to process information not previously possible. Our goal is to develop, implement and evaluate a mobile device (for example, PDA, mobile phone) food record that will translate to an accurate account of daily food and nutrient intake among adolescents. This mobile computing device will include digital images, a nutrient database and image analysis for identification and quantification of food consumption. Mobile computing devices provide a unique vehicle for collecting dietary information that reduces the burden on record keepers. Images of food can be marked with a variety of input methods that link the item for image processing and analysis to estimate the amount of food. Images before and after the foods are eaten can estimate the amount of food consumed. The initial stages and potential of this project will be described

Lack of association of two common polymorphisms on 9p21 with risk of coronary heart disease and myocardial infarction; results from a prospective cohort study

Background: Recent genome wide association (GWA) studies identified two Single Nucleotide Polymorphisms (SNP) (rs10757278 and rs10757274) in the region of the CDK2NA and CDK2NB genes to be consistently associated with the risks of coronary heart disease (CHD) and myocardial infarction (MI). We examined the SNPs in relation to the risk of CHD and MI in a large population based study of elderly population. Methods: The Rotterdam Study is a population-based, prospective cohort study among 7983 participants aged 55 years and older. Associations of the polymorphisms with CHD and MI were assessed by use of Cox proportional hazards analyses. Results: In an additive model, the age and sex adjusted hazard ratios (HRs) (95% confidence interval) for CHD and MI were 1.03 (0.90, 1.18) and 0.94 (0.82, 1.08) per copy of the G allele of rs10757274. The corresponding HRs were 1.03 (0.90, 1.18) and 0.93 (0.81, 1.06) for the G allele of rs10757278. The association of the SNPs with CHD and MI was not significant in any of the subgroups of CHD risk factors. Conclusion: We were not able to show an association of the studied SNPs with risks of CHD and MI. This may be due to differences in genes involved in the occurrence of CHD in young and older people

Case–control study of lifetime total physical activity and endometrial cancer risk

A population-based case–control study of physical activity and endometrial cancer risk was conducted in Alberta between 2002 and 2006. Incident, histologically confirmed cases of endometrial cancer (n = 542) were frequency age-matched to controls (n = 1,032). The Lifetime Total Physical Activity Questionnaire was used to measure occupational, household, and recreational activity levels. Multivariable logistic regression analyses were conducted. Total lifetime physical activity reduced endometrial cancer risk (odds ratio [OR] for >129 vs. <82 MET-h/week/year = 0.86, 95% confidence interval [95% CI]: 0.63, 1.18). By type of activity, the risks were significantly decreased for greater recreational activity (OR = 0.64, 95% CI: 0.47, 0.87), but not for household activity (OR = 1.09, 95% CI: 0.75, 1.58) and/or occupational activity (OR = 0.90, 95% CI: 0.67, 1.20) when comparing the highest to lowest quartiles. For activity performed at different biologically defined life periods, some indication of reduced risks with activity done between menarche and full-term pregnancy and after menarche was observed. When examining the activity by intensity of activity (i.e., light <3, moderate 3–6, and vigorous >6 METs), light activity slightly decreased endometrial cancer risk (OR = 0.68, 95% CI: 0.48, 0.97) but no association with moderate or vigorous intensity activity was found. Endometrial cancer risk was increased with sedentary occupational activity by 28% (95 CI%: 0.89, 1.83) for >11.3 h/week/year versus ≤2.4 h/week/year or by 11% for every 5 h/week/year spent in sedentary behavior. This study provides evidence for a decreased risk between lifetime physical activity and endometrial cancer risk and a possible increased risk associated with sedentary behavior

Nanoparticle–membrane interactions

Engineered nanomaterials have a wide range of applications and as a result, are increasingly present in the environment. While they offer new technological opportunities, there is also the potential for adverse impact, in particular through possible toxicity. In this review, we discuss the current state of the art in the experimental characterisation of nanoparticle-membrane interactions relevant to the prediction of toxicity arising from disruption of biological systems. One key point of discussion is the urgent need for more quantitative studies of nano-bio interactions in experimental models of lipid system that mimic in vivo membranes