Explaining ‘Brexit capital’: uneven development and the austerity state

The precise moment that triggered the EU referendum had its roots in the Europhobia that lurked within the soul of the Conservative Party. It has been deeply perturbing to witness such Europhobia played out in the form of an internal party political melodrama while the scandalous socio-economic fissures that fed the Brexit insurgence appeared to represent a mere side-show. Taking inspiration from recent work on Brexit as a critical conjuncture, this paper examines how part of this insurgence emerged as a ‘revolt of the regions’ led by communities that had endured sustained economic dispossession of public goods and services further exacerbated by the steadfast commitment by Conservative-led governments to a politics of austerity. In then sharpening the focus on to Stoke-on-Trent – baptized ‘Capital of Brexit’ in light of its status as the city with the highest Leave majority – the paper reveals deep-seated political disaffection as people railed against prolonged economic abandonment and social injustice. It further identifies how at the very heart of the Brexit conjuncture was a growing disconnect between citizens and the institutions of government, what amounts to a gradual exhaustion of consent for the neoliberal political economic mainstream. It has also resulted in a highly discordant state that is struggling to balance the process of extricating the UK from the EU with the management of a society that is now more imbalanced than at any time in living memory

Predictors of functional dependency in Parkinson’s disease

Financial disclosures/conflicts of interest: Dr Macleod was funded by a Clinical Academic Fellowship from the Chief Scientist Office of the Scottish Government and received grant funding from Parkinson’s UK, the Wellcome Trust, University of Aberdeen, and NHS Grampian endowments relating to this research. Dr Counsell received grant funding from Parkinson’s UK, National Institute for Health Research, the Scottish Chief Scientist Office, the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, NHS Grampian endowments and SPRING relating to this research. We declare we have no conflicts of interest. Financial support: This study was funded by Parkinson’s UK, the Scottish Chief Scientist Office, NHS Grampian endowments, the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, and SPRING.  Peer reviewedPublisher PD

Stroke patients admitted within normal working hours are more likely to achieve process standards and to have better outcomes

Acknowledgements The authors are grateful to David Murphy of the SSCA for providing data and to Lynsey Waugh of ISD Scotland for linking the SSCA data with General Register Office data. The authors also acknowledge the help of all who enter data into SSCA. Funding This study was funded by Chest, Heart and Stroke Scotland (Grant no R14/A156). The SSCA is funded by NHS Scotland via ISD.Peer reviewedPublisher PD

Development and validation of prognostic survival models in newly diagnosed Parkinson’s disease

Acknowledgments We would like to thank study participants, study personnel, and study funders. Funding agencies: The Parkinsonism Incidence in North-East Scotland (PINE) study was supported by Parkinson's UK (Grants G-0502, G-0914, G-1302), the Scottish Chief Scientist Office (CAF 12/05), the British Medical Association (BMA) Doris Hillier award, RS Macdonald Trust, the Bupa Foundation, National Health Service (NHS) Grampian endowments, NHS R&D, and SPRING. The ParkWest study was supported by the Research Council of Norway (Grant 177966), the Western Norway Regional Health Authority (Grants 911218 and 911949), and the Norwegian Parkinson's Disease Association.Peer reviewedPublisher PD

Interventions for post-stroke fatigue

BACKGROUND: Post-stroke fatigue (PSF) is a common and distressing problem after stroke. The best ways to prevent or treat PSF are uncertain. Several different interventions can be argued to have a rational basis. OBJECTIVES: To determine whether, among people with stroke, any intervention reduces the proportion of people with fatigue, fatigue severity, or both; and to determine the effect of intervention on health-related quality of life, disability, dependency and death, and whether such intervention is cost effective. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched May 2014), Cochrane Central Register of Controlled Trials (The Cochrane Library, 2014, Issue 4), MEDLINE (1950 to May 2014), EMBASE (1980 to May 2014), CINAHL (1982 to May 2014), AMED (1985 to May 2014), PsycINFO (1967 to May 2014), Digital Dissertations (1861 to May 2014), British Nursing Index (1985 to May 2014), PEDro (searched May 2014) and PsycBITE (searched May 2014). We also searched four ongoing trials registries, scanned reference lists, performed citation tracking of included trials and contacted experts. SELECTION CRITERIA: Two review authors independently scrutinised all titles and abstracts and excluded obviously irrelevant studies. We obtained the full texts for potentially relevant studies and three review authors independently applied the inclusion criteria. We included randomised controlled trials (RCTs) that compared an intervention with a control, or compared different interventions for PSF. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias for each included trial. The primary outcomes were severity of fatigue, or proportion of people with fatigue after treatment. We performed separate analyses for trials investigating efficacy in treating PSF, trials investigating efficacy in preventing PSF and trials not primarily investigating efficacy in PSF but which reported fatigue as an outcome. We pooled results from trials that had a control arm. For trials that compared different potentially active interventions without a control arm, we performed analyses for individual trials without pooling.We calculated standardised mean difference (SMD) as the effect size for continuous outcomes and risk ratio (RR) for dichotomous outcomes. We pooled the results using a random-effects model and assessed heterogeneity using the I(2) statistic. We performed separate subgroup analyses for pharmacological and non-pharmacological interventions. We also performed sensitivity analyses to assess the influence of methodological quality. MAIN RESULTS: We retrieved 12,490 citations, obtained full texts for 58 studies and included 12 trials (three from the 2008 search and nine from the 2014 search) with 703 participants. Eight trials primarily investigated the efficacy in treating PSF, of which six trials with seven comparisons provided data suitable for meta-analysis (five pharmacological interventions: fluoxetine, enerion, (-)-OSU6162, citicoline and a combination of Chinese herbs; and two non-pharmacological interventions: a fatigue education programme and a mindfulness-based stress reduction programme). The fatigue severity was lower in the intervention groups than in the control groups (244 participants, pooled SMD -1.07, 95% confidence interval (CI) -1.93 to -0.21), with significant heterogeneity between trials (I(2) = 87%, degrees of freedom (df) = 6, P value < 0.00001). The beneficial effect was not seen in trials that had used adequate allocation concealment (two trials, 89 participants, SMD -0.38, 95% CI -0.80 to 0.04) or trials that had used adequate blinding of outcome assessors (four trials, 198 participants, SMD -1.10, 95% CI -2.31 to 0.11).No trial primarily investigated the efficacy in preventing PSF.Four trials (248 participants) did not primarily investigate the efficacy on fatigue but other symptoms after stroke. None of these interventions showed any benefit on reducing PSF, which included tirilazad mesylate, continuous positive airway pressure for sleep apnoea, antidepressants and a self management programme for recovery from chronic diseases. AUTHORS' CONCLUSIONS: There was insufficient evidence on the efficacy of any intervention to treat or prevent fatigue after stroke. Trials to date have been small and heterogeneous, and some have had a high risk of bias. Some of the interventions described were feasible in people with stroke, but their efficacy should be investigated in RCTs with a more robust study design and adequate sample sizes

Pelican in the wilderness: symbolism and allegory in women’s evangelical songs of the Gàidhealtachd

The Pelican in the Wilderness: Symbolism and allegory in women’s evangelical songs of the Gàidhealtachd The Gaelic women’s song tradition has been studied in depth, and the post- Reformation Church and its impact on the Gàidhealtachd examined from various perspectives, yet the body of evangelical song which shows the interaction of the two is possibly the least explored area of traditional Gaelic verse and the least understood outside the immediate environment in which it was created. In their devotional songs, evangelical elegies and waulking songs, generations of women have left a record of the domestic, spiritual and cultural life of the Gàidhealtachd which would be difficult to retrieve from any other source. The present study provides access to this important literary and cultural resource by creating a research corpus of 600 poems, representing the work of 165 women from many different parts of the Gàidhealtachd, dating from the mid-eighteenth century to the present day. The historical, theological and literary background to the songs is explored, using both a range of secondary sources and the words of selected poets as they articulate and define contemporary events within the context of Reformed doctrine. Analysis across the corpus shows songs creating an allegorical world within which every creature, person and place is imbued with spiritual significance, each acting as a mnemonic for an associated biblical paradigm. This use of scriptural and doctrinal allusion is functional rather than purely ornamental, with core metaphors expressed and made authoritative in lexicons of honorifics, epithets and poetic place names. The thesis facilitates fuller reading of spiritual song by explaining the symbolic significance of the above elements, demonstrating their role in creating contextual settings, linking songs into a network of biblical, doctrinal and poetic texts, extending and validating the poet’s message. The functioning of this referential system is further explored in detailed literary analysis of the work of a representative sample of poets, each of whom is set in her own social and historical context