Domiciliary occupational therapy for patients with stroke discharged from hospital: randomised controlled trial

OBJECTIVE: To establish if a brief programme of domiciliary occupational therapy could improve the recovery of patients with stroke discharged from hospital. DESIGN: Single blind randomised controlled trial. SETTING: Two hospital sites within a UK teaching hospital. SUBJECTS: 138 patients with stroke with a definite plan for discharge home from hospital. INTERVENTION: Six week domiciliary occupational therapy or routine follow up. MAIN OUTCOME MEASURES: Nottingham extended activities of daily living score and "global outcome" (deterioration according to the Barthel activities of daily living index, or death). RESULTS: By eight weeks the mean Nottingham extended activities of daily living score in the intervention group was 4.8 points (95% confidence interval -0.5 to 10.0, P=0.08) greater than that of the control group. Overall, 16 (24%) intervention patients had a poor global outcome compared with 30 (42%) control patients (odds ratio 0.43, 0.21 to 0.89, P=0.02). These patterns persisted at six months but were not statistically significant. Patients in the intervention group were more likely to report satisfaction with a range of aspects of services. CONCLUSION: The functional outcome and satisfaction of patients with stroke can be improved by a brief occupational therapy programme carried out in the patient's home immediately after discharge. Major benefits may not, however, be sustained

Existing motor state is favored at the expense of new movement during 13-35 Hz oscillatory synchrony in the human corticospinal system

Oscillations in local field potentials in the β-frequency band (13-35 Hz) are a pervasive feature of human and nonhuman primate motor cortical areas. However, the function of such synchronous activity across populations of neurons remains unknown. Here, we test the hypothesis that β activity may promote existing motor set and posture while compromising processing related to new movements. Three experiments were performed. First, healthy subjects were instructed to make reaction time movements of the outstretched index finger in response to imperative cues triggered by transient increases in corticospinal synchrony, as evidenced by phasic elevations of β-frequency band microtremor and intermuscular synchrony. Second, healthy subjects were instructed to resist a stretch to the index finger triggered in the same way. Finger acceleration in the reaction time task and transcortical components of the stretch reflex were measured and compared with those elicited by random cue or stretch presentation. Finally, we sought a correlation between finger acceleration in the reaction time task and cortical synchrony directly measured from the electrocorticogram in two patients undergoing functional neurosurgery. We demonstrate that movements are slowed and transcortical responses to stretch are potentiated during periods of elevated β-band cortical synchrony. The results suggest that physiological periods of β synchrony are associated with a cortical state in which postural set is reinforced, but the speed of new movements impaired. The findings are of relevance to Parkinson's disease, in which subcortical and cortical β-band synchronization is exaggerated in the setting of increased tone and slowed movements

Digital inclusion - the vision, the challenges and the way forward

This paper considers the vision and aspiration of digital inclusion, and then examines the current reality. It looks beyond the rhetoric to provide an analysis of the status quo, a consideration of some facilitators and challenges to progress and some suggestions for moving forward with renewed energy and commitment. The far-reaching benefits of digital inclusion and the crucial role it plays in enabling full participation in our digital society are considered. At the heart of the vision of universal digital inclusion is the deceptively simple goal to ensure that everyone is able to access and experience the wide-ranging benefits and transformational opportunities and impacts it offers. The reality is a long way from the vision: inequality of access still exists despite many national campaigns and initiatives to reduce it. The benefits and beneficiaries of a digital society are not just the individual but all stakeholders in the wider society. Research evidence has shown that the critical success factors for successful digital participation are (i) appropriate design and (ii) readily available and on-going ICT (Information and Communication Technology) support in the community. Challenges and proven solutions are presented. The proposition of community hubs in local venues to provide user-centred ICT support and learning for older and disabled people is presented. While the challenges to achieve digital inclusion are very considerable, the knowledge of how to achieve it and the technologies which enable it already exist. Harnessing of political will is necessary to make digital inclusion a reality rather than a vision. With the cooperation and commitment of all stakeholders actualisation of the vision of a digitally inclusive society, while challenging, can be achieved and will yield opportunities and rewards that eclipse the cost of implementation

Audit Sampling Methods And Juror Negligence Awards: An Expectation Gap?

Generally accepted auditing standards permit auditors to apply both statistical and nonstatistical sampling techniques in obtaining sufficient, competent evidential matter.  However, several recent studies have shown that statistical sampling procedures have nearly disappeared from practice. Despite this trend and the heightened anxiety about professional liability, no studies to date have directly tested the potential implications of sampling method on jurors verdicts, damage awards, or sample size expectations.  In this study we investigate the effect of sampling method on jurors’ judgments in auditor negligence trials.  Overall, in a case where auditors were alleged to have used an insufficient sample size, the sampling method did not affect the likelihood of a “guilty of negligence” verdict.  However, as predicted, damage awards were significantly higher when nonstatistical sampling was used compared with statistical sampling.  Exploratory analysis revealed that subjects voting “guilty of negligence” would require the auditors to examine over 17% of the population (compared with the 1% examined) in order to change their verdict to “not guilty of negligence.”  These findings have troubling implications for auditors employing sampling techniques

High field magneto-transport in high mobility gated InSb/InAlSb quantum well heterostructures

We present high field magneto-transport data from a range of 30nm wide InSb/InAlSb quantum wells. The low temperature carrier mobility of the samples studied ranged from 18.4 to 39.5 m2V-1s-1 with carrier densities between 1.5x1015 and 3.28x1015 m-2. Room temperature mobilities are reported in excess of 6 m2V-1s-1. It is found that the Landau level broadening decreases with carrier density and beating patterns are observed in the magnetoresistance with non-zero node amplitudes in samples with the narrowest broadening despite the presence of a large g-factor. The beating is attributed to Rashba splitting phenomenon and Rashba coupling parameters are extracted from the difference in spin populations for a range of samples and gate biases. The influence of Landau level broadening and spin-dependent scattering rates on the observation of beating in the Shubnikov-de Haas oscillations is investigated by simulations of the magnetoconductance. Data with non-zero beat node amplitudes are accompanied by asymmetric peaks in the Fourier transform, which are successfully reproduced by introducing a spin-dependent broadening in the simulations. It is found that the low-energy (majority) spin up state suffers more scattering than the high-energy (minority) spin down state and that the absence of beating patterns in the majority of (lower density) samples can be attributed to the same effect when the magnitude of the level broadening is large

Wood-rotting Basidiomycetes--Itasca State Park Annotated List

This study reports 216 species of wood-rotting Basidiomycetes from Lake Itasca State Park in Minnesota. Of these, two species, Gloeocystidiellum heimii Boid. and Phanerochaete cumulodentata (Nikol) Parm., are reported for the first time from North America

Genetic diversity in curtoviruses: a highly divergent strain of Beet mild curly top virus associated with an outbreak of curly top disease in pepper in Mexico

A full-length curtovirus genome was PCR-amplified and cloned from peppers in Mexico with symptoms of curly top disease. The cloned DNA of this isolate, MX-P24, replicated in Nicotiana tabacum protoplasts and was infectious in N. benthamiana plants. Sequence analysis revealed that the MX-P24 isolate had a typical curtovirus genome organization and was most similar to beet mild curly top virus (BMCTV). However, sequence identities were at the threshold value for establishment of a new curtovirus species. To further investigate the biological properties of MX-P24, an agroinoculation system was generated. Agroinoculated shepherd’s purse plants developed typical curly top symptoms, and virus from these plants was transmissible by the beet leafhopper (Circulifer tenellus). The host range of MX-P24 was similar to that of BMCTV, with curly top symptoms induced in common bean, pepper, pumpkin, shepherd’s purse and tomato plants and mild or no symptoms induced in sugar beet plants. Together, these results indicate that MX-P24 is a highly divergent strain of BMCTV associated with an outbreak of curly top disease in peppers in Mexico

Second Biennial Watershed Management Workshop for the James, Vermillion, and Big Sioux Rivers

Watershed management means managing the South Dakota landscape. Many stakeholders are responsible for the landscape; therefore, cooperation, communication, knowledge, and a good sprinkling of wisdom must bring the various issues together for comprehensive watershed management. This watershed management workshop was a continuation of the first workshop held in Huron, S.D. in February of 1995. As with the first, the goals were to bring people together to discuss principles related to earth processes, natural resources, agronomy, range science, fish and wildlife, and human uses. A third of the workshop was devoted to learning about the diverse programs, projects, people, and funding that are already available. A series of • case histories of watershed management from South Dakota and other states was followed by a panel discussion

The relationship between Hippocampal asymmetry and working memory processing in combat-related PTSD: a monozygotic twin study

BACKGROUND: PTSD is associated with reduction in hippocampal volume and abnormalities in hippocampal function. Hippocampal asymmetry has received less attention, but potentially could indicate lateralised differences in vulnerability to trauma. The P300 event-related potential component reflects the immediate processing of significant environmental stimuli and has generators in several brain regions including the hippocampus. P300 amplitude is generally reduced in people with PTSD. METHODS: Our study examined hippocampal volume asymmetry and the relationship between hippocampal asymmetry and P300 amplitude in male monozygotic twins discordant for Vietnam combat exposure. Lateralised hippocampal volume and P300 data were obtained from 70 male participants, of whom 12 had PTSD. We were able to compare (1) combat veterans with current PTSD; (2) their non-combat-exposed co-twins; (3) combat veterans without current PTSD and (4) their non-combat-exposed co-twins. RESULTS: There were no significant differences between groups in hippocampal asymmetry. There were no group differences in performance of an auditory oddball target detection task or in P300 amplitude. There was a significant positive correlation between P300 amplitude and the magnitude of hippocampal asymmetry in participants with PTSD. CONCLUSIONS: These findings suggest that greater hippocampal asymmetry in PTSD is associated with a need to allocate more attentional resources when processing significant environmental stimuli.Timothy Hall, Cherrie Galletly, C.R. Clark, Melinda Veltmeyer, Linda J. Metzger, Mark W. Gilbertson, Scott P. Orr, Roger K. Pitman and Alexander McFarlan