Circulating Factor Seven Activating Protease (FSAP) in the Hyperacute Phase of Stroke

Background. Factor VII activating protease (FSAP) is a circulating serine protease that could be involved in the pathophysiology of stroke. We analyzed the temporal changes in FSAP antigen and FSAP activity after acute cerebral ischemia (ACI) and tested if FSAP could be used to differentiate between stroke subtypes in the hyperacute phase (<4.5 hours after symptom onset). Methods. Of the 118 suspected stroke patients enrolled, 76 had ACI; of which 20 suffered from large vessel occlusion (LVO), 19 had intracerebral hemorrhage (ICH), and 23 had stroke mimics. Median time from symptom onset to the two plasma sample collections, <4.5 hours, were 66 and 107 minutes for the entire study population. Additional samples were collected up to 90 days post stroke in a subset of ACI patients (). FSAP antigen, FSAP activity, FSAP-α2-antiplasmin-complex (FSAP-AP complex), and nucleosomes were measured by activity assays or ELISA. Results. ACI patients treated with tissue plasminogen activator (tPA) had elevated FSAP hours () that subsequently normalized after 6 hours. FSAP-AP complex levels decreased significantly from <4.5 hours () to 6 hours after symptom onset. tPA did not increase FSAP activity significantly in plasma in vitro. FSAP antigen significantly hours after symptom onset in LVO () and ICH () patients. FSAP could not differentiate ACI from ICH or strokes (ACI and ICH) from stroke mimics. FSAP did not correlate with stroke severity. Conclusion. LVO and ICH seem to influence FSAP levels in the hyperacute phase of stroke, but FSAP does not differentiate between stroke subtypes in a hyperacute setting.publishedVersio

‘If you look the part you’ll get the job’: should career professionals help clients to enhance their career image?

This article presents a critical exploration of the role of career professionals in supporting people to reflect on and enhance their appearance, attractiveness and self-presentation (career image). The article is conceptual and based on a review of the broader literature on career success, appearance and attractiveness. It explores the evidence for a relationship between attractiveness and career, and the authors propose a conceptual framework in which career image is comprised of three elements (interpersonal skills, aesthetic presentation and beauty). The paper examines a possible role for career professionals in relation to this and then critically examines this role and concludes with the proposition of a research agenda in this area

The political economy of competitiveness and social mobility

Social mobility has become a mainstream political and media issue in recent years in the United Kingdom. This article suggests that part of the reason for this is that it can serve as a mechanism to discuss policy concerns that appear to be about social justice without questioning important aspects of neo-liberal political economy. The article charts the policy rhetoric on social mobility under both New Labour and the current Coalition Government. It is argued first that under New Labour the apparent commitment to social mobility was in fact subsumed beneath the pursuit of neo-liberal competitiveness, albeit imperfectly realised in policy. Second, the article suggests that under the Coalition Government the commitment to raising levels of social mobility has been retained and the recently published Strategy for Social Mobility promises that social mobility is what the Coalition means when it argues that the austerity programme is balanced with ‘fairness’. Third, however, the Strategy makes clear that the Coalition define social mobility in narrower terms than the previous government. It is argued here that in narrowing the definition the connection with the idea of competitiveness, while still clearly desirable for the Coalition, is weakened. Fourth, a brief analysis of the Coalition's main policy announcements provides little evidence to suggest that even the narrow definition set out in the Strategy is being seriously pursued. Fifth, the international comparative evidence suggests that any strategy aimed at genuinely raising the level of social mobility would need to give much more serious consideration to narrowing levels of inequality. Finally, it is concluded that when considered in the light of the arguments above, the Strategy for Social Mobility – and therefore ‘Fairness’ itself – is merely a discursive legitimation of the wider political economy programme of austerity

Fear of movement and emotional distress as prognostic factors for disability in patients with shoulder pain: a prospective cohort study

Background: Shoulder pain is a prevalent and often long-lasting musculoskeletal disorder. The overall prognosis of shoulder pain is highly variable with 40-50% of patients reporting persistent pain 6-12 months after consulting a clinician. The evidence for psychological prognostic factors for patients with shoulder pain is inconsistent. Therefore, the objective of this study was to investigate the association between fear of movement and emotional distress at presentation and self-reported disability over one year of follow-up. Methods: This is a prospective cohort study of consecutive patients referred to secondary outpatient care due to shoulder pain. Consenting patients underwent a physical examination and completed a comprehensive questionnaire at baseline, three months-, and one-year follow-up. Associations between baseline fear of movement (0-10) or emotional distress (1-4), respectively, and patient reported disability measured using Quick Disability of the Arm and Shoulder (QuickDASH, 0-100) over one year were analyzed with linear mixed-effects models (LMM) for repeated measures (baseline, 3 months and 1 year), adjusting for established prognostic factors. Results: A total of 138 patients were recruited between March 2015 and January 2018, with response rates of 84.7% (n = 117) and 79.7% (n = 1 00) at three months and one year, respectively. Adjusted associations revealed that for every point increase in baseline fear of movement, the QuickDASH score increased (worsened) by 1.10 points (95% CI 0.2-2.0) over the follow-up year. For every point increase in baseline emotional distress, the QuickDASH score increased by 19.9 points (95% CI 13.9-25.9) from baseline over the follow-up year. Conclusion: Higher fear of movement and emotional distress scores at baseline were significantly associated with higher disability over one year in patients with shoulder pain referred to secondary care. Our study indicates that these psychological factors affect prognosis and should be considered by clinicians and researchers working with ipatients with shoulder pain

The production and reproduction of inequality in the UK in times of austerity

Inequality appears to be back on the intellectual and political agenda. This paper provides a commentary on this renewed interest, drawing on an empirical discussion of inequality in the UK. The paper argues that inequality should be seen as produced in the inherently unequal social relations of production, drawing attention to the role of social struggle in shaping dynamics of inequality. However, inequality is not just produced in dynamic class struggle in the formal economy, but also through the social reproduction of labour power on a day-to-day and inter-generational basis. As such, inequalities of household resources at any point in time may be reproductive of greater future inequality. It is argued that inequality has risen in the UK over recent decades because of changes in the social relations of production in the formal economy and social reproduction in the domestic sector, both of which have witnessed significant state interventions that have increased structural inequalities. It is argued that, absent of significant change, the underpinning structural dynamics in the UK will lead to further increases in inequality over the short and longer-term. Given this, we might expect to see an already emergent ‘New Politics of Inequality’ intensifying in the coming decades.n/

An Ontological Approach to Inform HMI Designs for Minimizing Driver Distractions with ADAS

ADAS (Advanced Driver Assistance Systems) are in-vehicle systems designed to enhance driving safety and efficiency as well as comfort for drivers in the driving process. Recent studies have noticed that when Human Machine Interface (HMI) is not designed properly, an ADAS can cause distraction which would affect its usage and even lead to safety issues. Current understanding of these issues is limited to the context-dependent nature of such systems. This paper reports the development of a holistic conceptualisation of how drivers interact with ADAS and how such interaction could lead to potential distraction. This is done taking an ontological approach to contextualise the potential distraction, driving tasks and user interactions centred on the use of ADAS. Example scenarios are also given to demonstrate how the developed ontology can be used to deduce rules for identifying distraction from ADAS and informing future designs