Microevolution of antimicrobial resistance and biofilm formation of Salmonella Typhimurium during persistence on pig farms

Salmonella Typhimurium and its monophasic variant S. 4,[5],12:i:- are the dominant serotypes associated with pigs in many countries. We investigated their population structure on nine farms using whole genome sequencing, and their genotypic and phenotypic variation. The population structure revealed the presence of phylogenetically distinct clades consisting of closely related clones of S. Typhimurium or S. 4,[5],12:i:- on each pig farm, that persisted between production cycles. All the S. 4,[5],12:i:- strains carried the Salmonella genomic island-4 (SGI-4), which confers resistance to heavy metals, and half of the strains contained the mTmV prophage, harbouring the sopE virulence gene. Most clonal groups were highly drug resistant due to the presence of multiple antimicrobial resistance (AMR) genes, and two clades exhibited evidence of recent on-farm plasmid-mediated acquisition of additional AMR genes, including an IncHI2 plasmid. Biofilm formation was highly variable but had a strong phylogenetic signature. Strains capable of forming biofilm with the greatest biomass were from the S. 4,[5],12:i:- and S. Typhimurium DT104 clades, the two dominant pandemic clones found over the last 25 years. On-farm microevolution resulted in enhanced biofilm formation in subsequent production cycle

Information overload : the differences that age makes

Information overload has long been studied as a phenomenon that causes problems at the personal, social and organisational level. This study investigates overload from a new angle, that of the influence of age on perceptions of information overload. A combination of questionnaires, interviews and diaries were used to gain insight into people’s perceptions towards information overload. It was found that people of all ages suffer from information overload but young people are primarily affected by information literacy levels while older people are affected by technology. There was evidence of a link between age and technology use. A link was also found between job role and information overload and the impact technology has had on the quantity of information available. This research will benefit anyone, either individually or within an organisation, looking for ways to combat information overload. It identifies the influence of age on various factors and recommends actions that may be taken to reduce information overload. In particular, recommendations were made for further training in technology and information literacy. The paper is based on an approach not seen before in the literature as it investigates the effects of age on information overload by seeking to understand how perceptions towards information overload may differ between different age groups. It is anticipated that this paper will trigger further studies that could focus on the effect of job role on information overload and the likelihood of information addiction becoming a future concern

Exploring good practice in life story work with people with dementia : the findings of a qualitative study looking at the multiple views of stakeholders

Introduction: Despite growing international interest in life story work as a tool for person-centred dementia care, there is little agreement on what constitutes good practice and little evidence from the perspectives of people with dementia or their family carers. Design and methods: This paper reports the findings from the qualitative element of a larger study looking at the feasibility of evaluating life story work. Ten focus groups were held with 73 participants: four groups of people with dementia (25 participants), three with family carers (21 participants), and three with staff, professionals and volunteers with experience of life story work (27 participants). Findings: It became apparent through our focus groups that, when people talk about ‘life story work’, different people mean different things. This related to both process and outcomes. In particular, a person with dementia may have very different views from others about what life story work is for and how their life story products should be used. There was general agreement that a good practice approach would be tailored to the individual needs and preferences of the person with dementia. However, in practice many settings used templates and the process was led by staff or completed by family carers. Conclusion: We produced nine key features of good practice which could be used to guide the life story work process. Key elements include: the recognition that not everyone will want to take part in life story work and that some people may even find it distressing; the importance of being led by the person with dementia themselves; the need for training and support for staff, carers and volunteers; and the potential for life story work to celebrate the person’s life today and look to the future

The Arctic and the UK: Climate, research and engagement

• The Arctic has warmed by around 2°C since 1850, approximately double the global average. Even if the Paris Agreement successfully limits global warming to a further 0.5°C, the Arctic is expected to warm by at least another 1°C. • The United Kingdom’s (UK) weather is linked to conditions in the European Arctic. For example, high atmospheric pressure in the Nordic Seas divert damaging storms across the UK and mainland Europe, with the potential to cause societal disruption from flooding. • It is possible, although presently unconfirmed, that alterations in Arctic conditions provoked the ‘Beast from the East’ winter storm in 2018. • Scientists need to take observations and improve their understanding of climatic processes in the Nordic Seas and the Arctic Ocean to fill gaps in knowledge about the links between the Arctic climate and the UK’s weather; a risk identified by the Intergovernmental Panel on Climate Change (IPCC). • The UK has significant research expertise and experience to understand how global warming will change the Arctic’s environment and affect the UK. • This strength, allied with the capabilities of the UK’s new polar research ship the RRS Sir David Attenborough, warrants an integrated programme of research, including advanced numerical modelling, to improve predictions of future extreme weather events. • Such a programme must acknowledge that the Arctic is politically an increasingly congested and contested space. It should be designed in collaboration with key Arctic and near-Arctic nations to increase the UK’s influence and abilit

Development of a psychological intervention for fatigue after stroke

Post-stroke fatigue (PSF) is common and distressing, but there is insufficient evidence to recommend any effective treatment for it. Psychological interventions are effective in treating fatigue in other conditions. This paper describes the development and evaluation of the feasibility of a psychological intervention for PSF.Based on psychological correlates of PSF and evidence-based psychological interventions for fatigue in other medical conditions, we developed a manualised psychological intervention for PSF, with input from stroke clinicians, psychological therapists, and stroke survivors. The intervention was delivered by a clinical psychologist to 12 participants with PSF to test its acceptability and feasibility. According to the feedback from participants and therapists, the intervention was refined for future use.The intervention consisted of six individual, face-to-face treatment sessions, and one follow-up, telephone-delivered booster session. It included psycho-education and discussion of strategies to promote physical and social activities and to challenge unhelpful thoughts. Four participants dropped out and the remaining eight participants completed the intervention. These eight participants also completed all assessments and feedback and reported fatigue levels as lower at the end of the study than at the baseline. All participants reported favourable opinions on the intervention and suggested that the last two treatment sessions be combined and the booster session be delivered in person as opposed to telephone.This psychological intervention was acceptable to stroke patients and was feasible in the local health service. These findings suggest that a randomised controlled trial to test efficacy is warranted

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy