1,070 research outputs found

    Lessons for Co-management: Experiences from the Fisheries Management Science Programme (FMSP)

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    The aim of this document is to communicate lessons for fisheries co-management that have emerged from a series of projects undertaken by the DFID Fisheries Management Science Programme (FMSP). It focuses on three examples of FMSP projects: ParFish, Adaptive learning and designing data collection systems. This document does not aim to give a comprehensive overview of co-management but seeks to provide a viewpoint based on the experiences of the FMSP projects in question. This document is targeted to fisheries decision makers, managers and facilitators including government, industry and non-governmental organisations

    Moving targets : nutritional geometry of development in solitary bee, Osmia bicornis

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    Eating the correct amount, and balance, of nutrients is key for fitness at the individual, and population level. Understanding dietary nutrient requirements and feeding behaviour is integral to addressing important questions, such as how an organism is able to respond and adapt to its nutritional environment, and the fitness consequences associated. We know that the relationships between nutrient intake and fitness can vary across different life stages, such as adults versus young. To date, the majority of studies have focused on single points in time or looked at overall patterns across whole life stages, and few have focused on age related shifts in nutritional requirements within a single life stage. In holometabolous insects, such as bees, the nutrients eaten during the larval stage have persistent effects on fitness. The majority of existing research in bee nutrition is limited to adults of social species, despite knowledge that most bee species are solitary. In this study, building on the work by Austin and Gilbert (2018), I re-focused the analysis onto weekly changes during the larval developmental period of important pollinator species, Osmia bicornis, to examine the changes over time in the relationship between nutrient consumption and fitness. I used data from nutritional geometry feeding experiments with six artificial protein-carbohydrate diets, two major macronutrients considered critical to insect development. I found that rules governing consumption changed over the developmental stage, and accordingly, so did the patterns of growth. I showed an age-related behavioural shift towards carbohydrate intake regulation. Macronutrient dilution of the diet carried costs to all measured traits. This study highlights that the rules governing feeding behaviour can be complex and dynamic, and could have important implications for the design of habitats for conservation of wild and domestic bees

    MEMORY AND METAMEMORY IN PATIENTS WITH TEMPORAL LOBE EPILEPSY

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    It is well established that patients with temporal lobe epilepsy (TLE) commonly report memory difficulties. The aim of this thesis was to use a novel approach adopting Nelson & Narens' (1990) theoretical framework to investigate whether metacognitive knowledge and memory performance were differentially disrupted in patients with TLE. More specifically, investigating to what extent poor memory in TLE could result from inadequate metamemory monitoring, inadequate metamemory control or both. Experiment I employed a combined Judgement-of-Learning and Feeling-of-Knowing task to investigate whether participants could monitor their memory successfully at both the item-by-item and global levels. The results revealed a dissociation between memory and metamemory in TLE patients. TLE patients presented with a clear episodic memory deficit compared with controls yet preserved metamemory abilities. Experiments 2 and 3 explored the sensitivity approach to examine metacognitive processes that operate during encoding in TLE patients and controls. Both these experiments demonstrated that TLE patients were sensitive to monitoring and control processes at encoding. The final experiment further investigated memory performance by examining the role of lateralisation of the seizure focus using material specific information and the 'Remember-Know' paradigm. The findings from the verbal task provided partial support to the material-specific hypothesis. The results from these experiments are discussed in terms of their association with executive functioning and memory deficits in TLE, and have important implications for future research examining memory and metamemory in TLE patients and other clinical populations.Derriford Hospital, Plymouth Hospitals NHS Trus

    Neural correlates of intrusion of emotion words in a modified Stroop task

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    Behavioural studies have demonstrated that the emotional Stroop task is a valuable tool for investigating emotion-attention interactions in a variety of healthy and clinical populations, showing that participants are typically more distracted by negative stimuli as compared to neutral or positive stimuli. The main aim of this study was to find and examine the neural correlates of this greater intrusion from negative emotional stimuli. Reliable reaction time (RT) and event-related potential (ER-P) data were collected from 23 participants who performed a manual emotional Stroop, task with short (40 ins) and long (500 ms) inter-trial intervals. In the short interval condition, participants were found to produce longer RTs for negative than neutral words, suggesting that these stimuli were more difficult to ignore. This RT effect disappeared in the long interval condition, although larger PI amplitudes were found for the negative words. This suggests that differences in early attention allocation may be unrelated to the degree of intrusion at the behavioural level. In addition, a larger negative slow wave around 300-700 ms post-stimulus was observed in the long interval condition, but only for those negative words that produced prolonged RTs as compared to their matched controls. This late and broadly distributed effect is believed to reflect suppression of meaning representations

    Ticagrelor in Acute Coronary Syndromes

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    The PLATO trial demonstrated significantly lower mortality and myocardial infarction in acute coronary syndrome (ACS) patients treated with ticagrelor and aspirin compared to clopidogrel and aspirin. Ticagrelor is a direct acting P2Y12 receptor antagonist, and is a more potent inhibitor of platelet reactivity than clopidogrel, and this is believed to be the main cause of its superior efficacy in the PLATO trial. A range of factors have been associated with high on-treatment platelet reactivity (HOTPR) on clopidogrel, including genetic factors, drug interactions and clinical risk factors. HOTPR on clopidogrel has been associated with a higher risk of adverse outcomes following ACS. On the basis of the PLATO trial results, and the theoretical limitations associated with clopidogrel, ticagrelor was funded by PHARMAC in July 2013, and has been recommended for use in patients with ACS in New Zealand. This thesis examined the use of ticagrelor in a real world ACS population being managed through Wellington Hospital cardiology department. We examined platelet reactivity in patients treated with ticagrelor compared to clopidogrel, factors associated with clinician choice to use ticagrelor versus clopidogrel and the incidence of side effects of ticagrelor that may have implications for compliance with the drug outside the setting of a randomized controlled trial. We found that ticagrelor significantly reduced both platelet reactivity (30.3 AU ± 17.5 versus 43.7 AU ± 24.8, p= 0.0001) and the proportion of patients classified as having HOTPR (15.9% versus 37.7%, p= 0.0001), in comparison to clopidogrel. The clinical variables associated with HOTPR differ between clopidogrel and ticagrelor, suggesting that different factors were driving residual platelet reactivity on the two agents. Over a 2 year period, clopidogrel (68%) was used more commonly than ticagrelor (42%), and in a different cohort of patients. Patients treated with ticagrelor were younger (61 years ± 10 versus 65 years ± 12, p=0.0001), less likely to present with STEMI (12% versus 31%, p=0.0001), less likely to have a history of prior myocardial infarction (15.8% versus 22.7%, p=0.05), and had lower GRACE (98 ± 24 versus 108 ± 28, p=0.0001) and CRUSADE (25 ± 9 versus 28 ± 12, p=0.001) risk scores compared to those treated with clopidogrel. Prescription of ticagrelor was therefore not driven by clinical risk. Antiplatelet prescription varied significantly according to the patients’ admitting hospital. Bleeding rates on ticagrelor and clopidogrel within 30 days of study enrolment were low and were not significantly different. There was 1 patient on clopidogrel who had the drug discontinued due to bleeding. At 30 day follow up, significantly more patients treated with ticagrelor reported dyspnoea (43.3% versus 27.1%, p=0.001), however discontinuation of the drug due to dyspnoea on ticagrelor was infrequent (1.7%). In this real world cohort of ACS patients, we observed that ticagrelor was associated with more potent platelet inhibition than clopidogrel, but was not associated with factors leading to increased discontinuation at 30 days. Despite the proven benefits of ticagrelor compared to clopidogrel, the majority of patients, including the highest risk patients appear to be preferentially treated with clopidogrel. The causes contributing to underuse of ticagrelor need to be examined and addressed

    Healthy Ageing in Europe:Prioritizing Interventions to improve Health Literacy

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    Background: Health literacy (HL) is low for 40-50% of the population in developed nations, and is strongly linked to many undesirable health outcomes. Older adults are particularly at risk. The Irohla project systematically created a large inventory of HL interventions targeting adults age 50+, to support practical production of policy and practice guidelines for promoting health literacy in European populations. Methods: We comprehensively surveyed international scientific literature, grey literature and other sources (published 2003+) for implemented HL interventions that involved older adults. Studies were screened for eligibility criteria and further selected for aspects important in European public health policy, including priority diseases, risk factors and vulnerable target groups. Interventions were prioritised using a multiple criteria tool to select final interventions that also featured strong evidence of efficacy and a broad range of strategies. Results: From nearly 7000 written summaries, 1097 met inclusion criteria, of which 233 were chosen for scoring and ranking. Of these, 7 had the highest multi-criteria scores. Eight more articles were selected based on rounded criteria including a high multi-criteria score as well as elements of innovation. Final selections were 18 articles describing 15 programmes. Conclusions: 15 promising intervention projects that feature strong evidence of efficacy among important diseases or risk factors and vulnerable groups, or that had success with elements of innovation were identified. These programmes have multiple positive attributes which could be used as guidance for developing innovative intervention programmes to trial on European older adults. They provide evidence of efficacy in addressing high priority diseases and risk factors

    Methodological review: quality of randomized controlled trials in health literacy

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    Background: The growing move towards patient-centred care has led to substantial research into improving the health literacy skills of patients and members of the public. Hence, there is a pressing need to assess the methodology used in contemporary randomized controlled trials (RCTs) of interventions directed at health literacy, in particular the quality (risk of bias), and the types of outcomes reported. Methods: We conducted a systematic database search for RCTs involving interventions directed at health literacy in adults, published from 2009 to 2014. The Cochrane Risk of Bias tool was used to assess quality of RCT implementation. We also checked the sample size calculation for primary outcomes. Reported evidence of efficacy (statistical significance) was extracted for intervention outcomes in any of three domains of effect: knowledge, behaviour, health status. Demographics of intervention participants were also extracted, including socioeconomic status. Results: We found areas of methodological strength (good randomization and allocation concealment), but areas of weakness regarding blinding of participants, people delivering the intervention and outcomes assessors. Substantial attrition (losses by monitoring time point) was seen in a third of RCTs, potentially leading to insufficient power to obtain precise estimates of intervention effect on primary outcomes. Most RCTs showed that the health literacy interventions had some beneficial effect on knowledge outcomes, but this was typically for less than 3 months after intervention end. There were far fewer reports of significant improvements in substantive patient-oriented outcomes, such as beneficial effects on behavioural change or health (clinical) status. Most RCTs featured participants from vulnerable populations. Conclusions: Our evaluation shows that health literacy trial design, conduct and reporting could be considerably improved, particularly by reducing attrition and obtaining longer follow-up. More meaningful RCTs would also result if health literacy trials were designed with public and patient involvement to focus on clinically important patient-oriented outcomes, rather than just knowledge, behaviour or skills in isolation
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