Comparisons between group- and individual-based interventions to support recovery from stroke and ischaemic heart disease in the community: a scoping review

Purpose To map and summarise available literature on the effectiveness or other benefits of group- and individual-based interventions provided for adults living with stroke or ischaemic heart disease (IHD) in the community. Material and Methods The review was conducted based on JBI methodology and reported using Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Articles were retrieved from: Medline, PsychInfo, Embase, Scopus, and CINAHL from 2002–2022. Extracted data from eligible studies included type of health outcomes (e.g., impairments), retention and adherence, social connectedness, and the costs associated with group- and individual-based interventions. Results After screening, five articles (representing 4 unique studies) comparing a group- and individual-based intervention were included (total sample size n = 87). Three types of interventions were assessed: exercise (3/5), communication (1/5), and occupational therapy (1/5). Effectiveness of group- and individual-based interventions at improving health outcomes (i.e. physical ability, communication, motivation, and quality of life) is unclear. Currently there is insufficient evidence to guide clinical practice. Conclusions There is limited evidence comparing interventions delivered in a group and individual modality for adults living with stroke or IHD. Adequately powered studies are needed to determine if mode of delivery is equivalent or more cost effective. IMPLICATIONS FOR REHABILITATION Rehabilitation interventions can be offered individually or in group settings with clinicians choosing the most appropriate modality. Both group- and individual-based interventions have advantages and disadvantages, with clinical, practical, and economic factors as important considerations when deciding between the two modalities. Based on this scoping review, the authors conclude that there is currently insufficient evidence to guide clinical practice in deciding which mode of delivery (group or individual) is optimal. There is insufficient research evidence to guide clinicians in their choice between offering rehabilitation interventions for stroke or IHD in groups or individually

Local Suppression of T Cell Responses by Arginase-Induced L-Arginine Depletion in Nonhealing Leishmaniasis

The balance between T helper (Th) 1 and Th2 cell responses is a major determinant of the outcome of experimental leishmaniasis, but polarized Th1 or Th2 responses are not sufficient to account for healing or nonhealing. Here we show that high arginase activity, a hallmark of nonhealing disease, is primarily expressed locally at the site of pathology. The high arginase activity causes local depletion of L-arginine, which impairs the capacity of T cells in the lesion to proliferate and to produce interferon-γ, while T cells in the local draining lymph nodes respond normally. Healing, induced by chemotherapy, resulted in control of arginase activity and reversal of local immunosuppression. Moreover, competitive inhibition of arginase as well as supplementation with L-arginine restored T cell effector functions and reduced pathology and parasite growth at the site of lesions. These results demonstrate that in nonhealing leishmaniasis, arginase-induced L-arginine depletion results in impaired T cell responses. Our results identify a novel mechanism in leishmaniasis that contributes to the failure to heal persistent lesions and suggest new approaches to therapy

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

NCDS / BCS70 partnership history datasets

The partnership history datasets are major additions to the BCS70 and NCDS cohort studies. These long-running birth cohort studies are unique in the world because they have followed largely nationally representative samples of individuals from birth through childhood and adult life. The datasets are highly original output that include data on all live-in relationships that lasted one month or more , collected across all data sweeps undertaken since the cohort members reached age 16. These partnership data are merged into single longitudinal datasets, providing rich new empirical material for a wide range of researchers. The BCS70 partnership dataset includes 72 variables and contains 30,949 partnership records for 19,101 cohort members, with 11,432 cohort members having at least 1 partnership recorded. The NCDS activity dataset includes 72 variables and contains 31,437 partnership records for 18,558 cohort members, with 12,417 cohort members having at least 1 adult partnership recorded. The partnership data was collected as part of surveys which achieved high responses rates, underscoring the rigourous methods used to collect the data and the consistent work to maintain contact with cohort members over many years. Ethical issues were carefully considered in designing the studies. The significance of the datasets has already been demonstrated through its use by a great many researchers to produce high-quality published outputs. For example zzz individuals have downloaded the datasets since month 2010 and the CLS bibliography lists yyy journal articles that have been published based on the data since January 2011. The data sets also have considerable potential future significance. The multi- user data sets will continue to be used in years to come as researchers use the partnership history data, in conjunction with the rich cohort data collected across a variety of domains for the same individuals, to explore the effects of health, work and housing on partnerships and vice versa

Dedicated Education Units: Bridging the Gap between Education and Practice

The traditional clinical model brings the challenges of nurse faculty shortage, lack of available clinical sites, and quality of student experiences given faculty-student ratios (Smyer, Gatlin, Tan, Tejada &Du, 2015). According to the Institute for Healthcare Improvement (IHI), changing exemplars of patient care require new models of clinical education to encourage independent clinical thinking and judgment (IHI, n.d). The Dedicated Education Unit (DEU) is gaining popularity in the United States and has demonstrated positive outcomes for students, nurses, and patients

Childhood parental bereavement: The risk of vulnerability to delinquency and factors that compromise resilience

Background: In previous research, it has been established that a child who has experienced the death of a parent is vulnerable to a variety of concerns, including grief, distress and dysphoria, particularly in the first year following the death. In addition, one in five parentally-bereaved children is likely to develop a psychiatric disorder. As Kemshall argues, the growing body of evidence linking delinquency in adolescents to previous traumatic life experiences, such as parental loss, with a large number of children affected every year makes this is a very important area for research. This paper considers the effects of parental bereavement in childhood, and is part of a wider study exploring the future for children who experience a parent's death. We found that parentally-bereaved children are significantly more vulnerable to delinquent behaviour than those who have not experienced parental bereavement. Thus there is a need for awareness of the variables that form protectors to the vulnerability to delinquency formed, in part by the experience of a parent's death. Methods: We used secondary data from the National Child Development study from which children who had been parentally bereaved by the age of 16 were identified. The Rutter Behaviour Scale highlighted which of those children also displayed delinquent behaviours; the Pearson Chi Square was used to establish significant links between these two factors. Potential moderating factors of social class background, gender of child, gender of dead parent and age of child at the time of bereavement were also examined. Results: The findings present as a set of risk variables that increase a child's susceptibility to delinquent behaviour, with specific reference to children who have been parentally bereaved. Children who were parentally bereaved before the age of 16 were significantly more likely to display delinquent behaviour than those who were not, as indicated by scoring 9 or above, the cut off point on the Rutter Behaviour Scale (p < .001). These scores of 9+ at 16 are significantly more likely (p < .001) for children who were bereaved between the ages of 12 and 16 years. For all children (including children not parentally bereaved), boys were significantly more likely than girls to score 9+ on the Rutter Behaviour Scale at 16 (p < .001). However, gender was not a significant factor in parentally-bereaved children, indicating parentally-bereaved girls are more likely to display similar levels of delinquent behaviour to non-parentally-bereaved boys. Children from manual backgrounds are significantly more likely than those from non-manual backgrounds to be parentally bereaved (p < .001)

1970 British Cohort Study : Thirty-Eight-Year Follow-Up, 2008-2009

The 1970 British Cohort Study (BCS70) began in 1970 when data were collected about the births and families of babies born in the United Kingdom in one particular week in 1970. The first wave, called the British Births Survey, was carried out by the National Birthday Trust Fund in association with the Royal College of Obstetricians and Gynaecologists. Its aims were to examine the social and biological characteristics of the mother in relation to neonatal morbidity, and to compare the results with those of the National Child Development Study (NCDS), which commenced in 1958 (held separately at the UK Data Archive under GN 33004). Participants from Northern Ireland, who had been included in the birth survey, were dropped from the study in all subsequent sweeps, which only included respondents from Great Britain. Since BCS70 began, there have been seven full data collection exercises in order to monitor the cohort members' health, education, social and economic circumstances. These took place when respondents were aged 5, in 1975 (held under SN 2699), aged 10, in 1980 (SN 3723), aged 16, in 1986 (SN 3535), aged 26, in 1996 (SN 3833), aged 30, 1999-2000 (SN 5558), and aged 34, in 2004-2005 (SN 5585). The first two sweeps (at 5 and 10 years) were carried out by the Department of Child Health at Bristol University. During these times, the survey was known as the Child Health and Education Study (CHES). The 16-year survey was carried out by the International Centre for Child Studies and named Youthscan. The Social Statistics Research Unit (SSRU) became involved with the BCS70 study at this time, and eventually changed its name to the Centre for Longitudinal Studies (CLS), based at the Institute of Education, University of London. With each successive attempt, the scope of BCS70 has broadened from a strictly medical focus at birth, to encompass physical and educational development at the age of 5, physical, educational and social development at the ages of 10 and 16, and physical, educational, social and economic development at 26 years and beyond. Further information about the BCS70 and may be found on the Centre for Longitudinal Studies website. As well as BCS70, the CLS now also conducts the NCDS series. The 1970 British Cohort Study: Thirty-Eight-Year Follow-up, 2008-2009 was conducted when respondents were aged 38. The latest sweep was conducted for the first time as a telephone interview (CATI). The main aim of the most recent survey was to explore the factors central to the formation and maintenance of adult identity in each of the following domains: •lifelong learning •relationships, parenting and housing •employment and income •health and health behaviour •citizenship and values For the third edition (May 2013) a new derived variables data file was deposited with accompanying documentation. See the documents covering Derived Variables and Region Variables for further details. Main Topics: The survey explored the following areas: •housing •relationship history •births and other pregnancies •periods of lone parenthood •children and the wider family (social relationships and support) •family income •employment status/employment history •academic education •general health •smokin

National Child Development Study : Sweep 8, 2008-2009 Dataset

The National Child Development Study (NCDS) is a continuing longitudinal study that seeks to follow the lives of all those living in Great Britain who were born in one particular week in 1958. The aim of the study is to improve understanding of the factors affecting human development over the whole lifespan. The NCDS has its origins in the Perinatal Mortality Survey (PMS) (the original PMS study is held at the UK Data Archive under SN 2137). This study was sponsored by the National Birthday Trust Fund and designed to examine the social and obstetric factors associated with stillbirth and death in early infancy among the 17,000 children born in England, Scotland and Wales in that one week. Selected data from the PMS form NCDS sweep 0, held alongside NCDS sweeps 1-3, under SN 5565. To date there have been seven attempts to trace all members of the birth cohort in order to monitor their physical, educational and social development. The first three sweeps were carried out by the National Children's Bureau, in 1965, when respondents were aged 7, in 1969, aged 11, in 1974, aged 16 (these sweeps form NCDS1-3, held together with NCDS0 under SN 5565). The fourth sweep, NCDS4, was conducted in 1981, when respondents were aged 23 (held under SN 5566). In 1985 the NCDS moved to the Social Statistics Research Unit (SSRU) - now known as the Centre for Longitudinal Studies (CLS) - and the fifth sweep was carried out in 1991, when respondents were aged 33, (NCDS5, held under SN 5567). For the sixth wave, conducted in 1999-2000, when respondents were aged 41-42 (NCDS6, held under SN 5578), fieldwork was combined with the 1999-2000 wave of the 1970 Birth Cohort Study (BCS70), which is also is held under SN 6942. The 7th wave was conducted in 2004-5 when study members were aged 46. This follow-up was conducted by telephone for the first time. NCDS8: The eighth sweep of NCDS was conducted in 2008-2009, when respondents were aged 50 years. The core aims of the NCDS8 were to update the life history information collected in previous studies and to collect new information to help understand the ageing process. Many of the questions in the NCDS8 follow-up had been asked in earlier waves of the NCDS and the BCS, which will allow for the making of comparisons both across the sweeps of NCDS and with the BCS cohort. The 2008-2009 survey is comprised of the following elements: •a 55 minute a 'core' interview (included a Computer Assisted Personal Interview (CAPI); Computer Assisted Self Interview (CASI); a series of cognitive assessments) •a paper questionnaire Main Topics: CAPI interview: The CAPI interview collected updated information about household composition, housing, relationships, births and other pregnancies, periods of lone parenthood, adopted children, absent and older children, parents, family income, economic activity, education and qualifications, work-related training, use of computers, health, smoking, drinking, exercise, height, weight, social participation and social support. CASI interview: The CASI interview collected information on voting behaviour and party support, experience of symptoms of the menopause, problematic drinking behaviour, well-being, relationship satisfaction, domestic division of labour, job commitment, attitudes towards pensions and retirement, childhood, efficacy and life satisfaction. Standard Measures The interview included several established scales: Kanungo's Job Involvement Scale; the AUDIT (Alcohol Use Disorders Identification Test) and the Malaise The cognitive assessment module is comprised of four tasks: Word list recall test; Animal naming task; Letter cancellation task; Delayed word list recall test

Drug-like sphingolipid SH-BC-893 opposes ceramide-induced mitochondrial fission and corrects diet-induced obesity.

Ceramide-induced mitochondrial fission drives high-fat diet (HFD)-induced obesity. However, molecules targeting mitochondrial dynamics have shown limited benefits in murine obesity models. Here, we reveal that these compounds are either unable to block ceramide-induced mitochondrial fission or require extended incubation periods to be effective. In contrast, targeting endolysosomal trafficking events important for mitochondrial fission rapidly and robustly prevented ceramide-induced disruptions in mitochondrial form and function. By simultaneously inhibiting ARF6- and PIKfyve-dependent trafficking events, the synthetic sphingolipid SH-BC-893 blocked palmitate- and ceramide-induced mitochondrial fission, preserved mitochondrial function, and prevented ER stress in&nbsp;vitro. Similar benefits were observed in the tissues of HFD-fed mice. Within 4&nbsp;h of oral administration, SH-BC-893 normalized mitochondrial morphology in the livers and brains of HFD-fed mice, improved mitochondrial function in white adipose tissue, and corrected aberrant plasma leptin and adiponectin levels. As an interventional agent, SH-BC-893 restored normal body weight, glucose disposal, and hepatic lipid levels in mice consuming a HFD. In sum, the sphingolipid analog SH-BC-893 robustly and acutely blocks ceramide-induced mitochondrial dysfunction, correcting diet-induced obesity and its metabolic sequelae