Promoting positive communication environments: a service evaluation.

Purpose The purpose of this paper is to present an evaluation of a programme of training and support provided to staff, which aimed to encourage supported communication environments for people with learning disabilities. Design/methodology/approach Training, monitoring and support for communication, specifically augmentative and alternative communication (AAC) strategies, was provided by speech and language therapy staff to two residential services over 46 weeks. Staff and service user communications were observed pre- and post-intervention. Findings In one provision there was an increase in service user initiations and the use of some AAC strategies by support staff. In the other provision there was no change in service user initiations and a decrease in the range of AAC strategies used. It appears that some forms for AAC remain challenging for staff to implement. Originality/value This evaluation explores ways of using specialist support services to improve communication environments for people with learning difficulties. Possible reasons for differences in the outcome of the intervention are discussed. Future research into the types of communication interactions experienced by people with learning disabilities across the range of communication styles may be useful so that support staff can be better helped to provide sustained and enriched communication environments

Secular trends in under-reporting in young people

Original article can be found at: http://journals.cambridge.org/action/displayJournal?jid=BJN Copyright The Authors. DOI: 10.1079/BJN20041307National survey data show that reported energy intake has decreased in recent decades despite a rise in the prevalence of obesity. This disparity may be due to a secular increase in under-reporting or a quantitatively greater decrease in energy expenditure. This study examines the extent of under-reporting of energy intake in the National Diet and Nutrition Survey (NDNS) in young people aged 4–18 years in 1997 using published equations to calculate estimated energy requirements. It explores secular changes by comparison with the Diets of British School Children (DBSC) survey in 10–11- and 14–15-year-olds in 1983. In the NDNS, under-reporting (estimated energy requirements – energy intake) represented 21 % of energy needs in girls and 20 % in boys. The magnitude of under-reporting increased significantly with age (P<0·001) and was higher in overweight than lean individuals over 7 years of age. To compare reported energy intake in DBSC and NDNS, the estimated physical activity level from dietary records (dPAL=reported energy intake/predicted BMR) was calculated. If there were no under-reporting, dPAL would represent the subject's true activity level. However, dPAL from the NDNS was significantly lower than that from the DBSC by 8 % and 9 % in boys and girls for those aged 10–11 years, and by 14 % and 11 % for 14–15-year-olds respectively, reaching physiologically implausible levels in the 14–15-year-old girls (dPAL=1·17). If activity levels have remained constant between the two surveys, under-reporting has increased by 8–14 %. The evidence supports a secular trend towards increased under-reporting between the two surveys, but the precise magnitude cannot be quantified in the absence of historical measures of energy expenditure.Peer reviewe

Joint gravitational wave -- gamma-ray burst detection rates in the aftermath of GW170817

The observational follow-up campaign of the gravitational wave (GW) multi-messenger event GW170817/GRB170817A has shown that the prompt $\gamma$-rays are consistent with a relativistic structured jet observed from a wide viewing angle $\gtrsim 20$\deg. We perform Bayesian inference using the data from early and late EM observations to determine the jet profile of GRB170817A assuming a structured jet model. We use the geometric dependence on the burst luminosity to produce a short duration gamma-ray burst (sGRB) efficiency function with redshift, which folded in with binary neutron star detection rate, allows us to estimate the future joint GW/sGRB detection rates for LIGO and Virgo detectors. We show that, if the jet structured profile of GRB170817A is a relatively common feature of sGRBs, then there is a realistic probability of another off-axis coincident detection during the third aLIGO/Virgo observing run (O3). We also find that up to 4 yr$^{-1}$ joint events may be observed during the advanced LIGO run at design sensitivity and up to 10 yr$^{-1}$ by the upgraded advanced LIGO configuration A+. We show that the detection efficiencies for wide-angled sGRB emissions will be limited by GRB satellites as the GW detection range increases through proposed upgrades. Therefore, although the number of coincident detections will increase with GW detector sensitivity, the relative proportion of detected binary neutron stars with $\gamma$-ray counterparts will decrease; 11\% for O3 down to 2\% during A+.Comment: Updated to final accepted MNRAS versio

Effects of five years of frequent N additions, with or without acidity, on the growth and below-ground dynamics of a young Sitka spruce stand growing on an acid peat: implications for sustainability

International audienceA field manipulation study was established to demonstrate effects of simulated wet N and S deposition on a young (planted 1986) stand of Sitka spruce growing on a predominantly organic soil in an area of low (8?10 kg N ha-1 yr-1) background N deposition in the Scottish borders. From 1996, treatments (six) were applied to the canopies of ten-tree plots in each of four blocks. N was provided as NH4NO3, either with H2SO4 (pH 2.5) at 48 or 96 kg N ha-1 yr-1 inputs or without, at 48 kg N ha-1 yr-1 along with wet (rain water) and dry controls (scaffolding) and a S treatment (Na2SO4). Positive responses (+ >20% over 5 years) with respect to stem area increment were measured in response to N inputs, irrespective of whether acid was included. The positive response to N was not dose related and was achieved against falling base cation concentrations in the foliage, particularly with respect to K. The results suggest young trees are able to buffer the low nutrient levels and produce new growth when there is sufficient N. Inputs of 96 kg N ha-1 yr-1, in addition to ambient N inputs, on this site exceeded tree demand resulting in elevated foliar N, N2O losses and measurable soil water N. These excessive N inputs did not reduce stem area growth. Keywords: acid, canopy application, nitrogen, acid organic soil, simulated wet deposition, soil water, sulphur, young Sitka spruc

Feminism, Abortion and Disability: irreconcilable differences?

There has been considerable discussion of the political allegiance between the feminist and disability movements, but the question of abortion remains a thorny one. Disability rights advocates have been keen to demonstrate that it is possible to believe in a woman's right to sovereignty over the body and, yet, be opposed to the selective abortion of an impaired foetus – describing the latter as a form of 'weak' eugenics. The aim of this paper is to show that whilst there may be some points of agreement between the feminist and disability movements on the question of abortion, there exist fundamental and irreconcilable differences

An unblinded, randomised phase II study of platinum-based chemotherapy with vitamin B12 and folic acid supplementation in the treatment of lung cancer with plasma homocysteine blood levels as a biomarker of severe neutropenic toxicity

BACKGROUND: Vitamin B12 and folic acid (referred to as vitamin supplementation) improves the toxicity profile of pemetrexed containing regimens. Low baseline vitamin B12 and folate levels are reflected in a raised total homocysteine level (HC). Studies have suggested that pretreatment HC levels predict neutropenia toxicity. We have tested supplementation with vitamin B12 and folate in non-pemetrexed platinum-based regimens to decrease treatment-related toxicity and looked for a correlation between toxicity and change in homocysteine levels. PATIENT AND METHOD: Eighty-three patients with advanced lung cancer and malignant mesothelioma were randomly assigned to receive platinum-based chemotherapy with (arm A) or without (arm B) vitamin B12 and folic acid supplementation. The primary end point was grade 3/4 neutropenia and death within 30 days of treatment. Secondary end points included quality of life, overall survival (OS) and the relationship between baseline and post supplementation HC levels and toxicity. RESULTS: In the intention-to-treat population, no significant difference was seen between the two groups with respect to chemotherapy-induced grade 3/4 neutropenia and death within 30 days of chemotherapy (36% vs 37%; p=0.966, emesis (2% vs 6%; p=0.9) or OS (12.3 months vs 7 months; p=0.41). There was no significant difference in survival rates by baseline HC level (p=0.9). Decrease in HC with vitamin supplementation was less frequent than expected. High baseline HC levels decreased with vitamin supplementation in only 9/36 (25%) patients (successful supplementation). Post hoc analysis showed that patients in arm A who were successfully supplemented (9/36=25%) had less neutropenic toxicity (0% vs 69%; p=0.02) compared to unsupplemented patients. CONCLUSIONS: The addition of vitamin B12 and folic acid to platinum-containing regimens did not overall improve the toxicity, quality of life or OS. Rates of grade 3/4 neutropenia at 36/37% was as predicted. Further studies to increase the rate of successful supplementation and to further test the biomarker potential of post supplementation HC levels in predicting chemotherapy-induced neutropenia in platinum-based chemotherapy are warranted. TRIAL REGISTRATION NUMBER: EudracCT 2005-002736-10 ISRCTN8734355

Transmission and dose–response experiments for social animals: a reappraisal of the colonization biology of Campylobacter jejuni in chickens

Dose-response experiments characterize the relationship between infectious agents and their hosts. These experiments are routinely used to estimate the minimum effective infectious dose for an infectious agent, which is most commonly characterized by the dose at which 50 per cent of challenged hosts become infected-the ID(50). In turn, the ID(50) is often used to compare between different agents and quantify the effect of treatment regimes. The statistical analysis of dose-response data typically makes the assumption that hosts within a given dose group are independent. For social animals, in particular avian species, hosts are routinely housed together in groups during experimental studies. For experiments with non-infectious agents, this poses no practical or theoretical problems. However, transmission of infectious agents between co-housed animals will modify the observed dose-response relationship with implications for the estimation of the ID(50) and the comparison between different agents and treatments. We derive a simple correction to the likelihood for standard dose-response models that allows us to estimate dose-response and transmission parameters simultaneously. We use this model to show that: transmission between co-housed animals reduces the apparent value of the ID(50) and increases the variability between replicates leading to a distinctive all-or-nothing response; in terms of the total number of animals used, individual housing is always the most efficient experimental design for ascertaining dose-response relationships; estimates of transmission from previously published experimental data for Campylobacter spp. in chickens suggest that considerable transmission occurred, greatly increasing the uncertainty in the estimates of dose-response parameters reported in the literature. Furthermore, we demonstrate that accounting for transmission in the analysis of dose-response data for Campylobacter spp. challenges our current understanding of the differing response of chickens with respect to host-age and in vivo passage of bacteria. Our findings suggest that the age-dependence of transmissibility between hosts-rather than their susceptibility to colonization-is the mechanism behind the 'lag-phase' reported in commercial flocks, which are typically found to be Campylobacter free for the first 14-21 days of life.A.J.K.C. is funded by DEFRA grant PU/T/WL/07/46 - SE3230, sponsored by the Veterinary Laboratories Agency. This research was developed during an earlier project funded by the Biotechnology and Biological Sciences Research Council/Defra Government Partnership Award, grants BB/500852/1 and BB/500936/1

A comparison of proteins and peptides as substrates for microsomal and solubilized oligosaccharyltransferase

A chemoenzymatic synthesis of homogeneous neoglycoproteins and glycopeptides was explored using oligosaccharyltransferase isolated from yeast. Neither the microsomal form nor the solubilized form of the enzyme catalyzed the transfer of the core Glc3Man9(GlcNAc)2 oligosaccharide to chemically modified ribonuclease A or [alpha]-lactalbumin. Similarly, no transfer was observed to the 32-amino acid peptide hormone, calcitonin, by either the membrane-bound or soluble form of oligosaccharyltransferase. However, a 17-amino acid fragment of yeast invertase with the unusual sequence containing two overlapping glycosylation sequons proved to be a good substrate, slightly less effective than the well studied tripeptide, Bz-Asn-Leu-Thr-NH2. Product analysis using gel permeation chromatography showed that the expected glycopeptides were formed and endo H-catalyzed cleavage of the oligosaccharide portion from the glycopeptides demonstrated that the glycopeptides contained the same carbohydrate moiety.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31237/1/0000142.pd