Is resistance to ischaemia of motor axons in diabetic subjects due to membrane depolarization?

The reasons for the resistance to ischaemia of peripheral nerves in diabetics are not well understood. We have now explored whether axonal depolarization underlies this phenomenon, as has previously been proposed. Resistance to ischaemia was determined by the new method of “threshold tracking”. This method revealed an increase in excitability of the peroneal nerve at the popliteal fossa during ischaemia, and a decrease in excitability in the post-ischaemic period. The extent of these alterations in 28 type 1 diabetics without peripheral neuropathy showed a strong correlation with the mean blood glucose concentrations during the last 24 h before examination. To test whether the ischaemic resistance was related to membrane potential, we also measured axonal superexcitability in 11 selected diabetics, since it has been shown that post-spike changes in excitability depend on membrane potential. Changes in excitability of the peroneal nerve were measured in the period between 10 and 30 msec following a conditioning supramaximal compound action potential. Under resting conditions, no differences in the post-spike superexcitability were found between controls and diabetics, despite striking differences in their responses to a 10-min pressure cuff. These observations indicate that membrane depolarization is not involved in the resistance to ischaemia of motor axons in diabetic subjects

The Aquaculture knowledge economy: boom or bust?

We live in an age of unprecedented growth in knowledge generation and exchange. The links between knowledge, innovation and economic development are frequently promoted. Government policies for enhancing education and training opportunities in a widening framework of Lifelong Learning are becoming increasingly central themes in strategies for economic recovery and growth. However, there is little evidence that more of the same i.e. traditionally structured education and training, is leading to the innovation and growth that policymakers desire. Graduate unemployment rates in Europe are reaching new highs and when new graduates are employed, it is often in lower skilled jobs than would have been the case in the past. In many ways it looks to be an economy of abundance; a massive increase in the availability of explicit knowledge gradually devaluing the people seeking employment on the basis of their accredited knowledge and skills. However, other interpretations are possible, not least that society generally, and large organisations and institutions in particular, are failing to grasp the opportunities that knowledge generation and exploitation can bring. The aquaculture sector is truly global and highly diverse; in parts relying on traditional tacit knowledge and elsewhere on the most recently generated explicit knowledge. A broader understanding of the role of different types of knowledge for aquaculture enterprise, and a deeper understanding of how that knowledge is generated, shared and communicated can provide a platform for dialogue and potentially new initiatives. Pointers for the future can also be found in new knowledge generating and sharing activities that are emerging on the Internet, and in different models of enterprise organisation found in innovative start-up companies. One interpretation is that lifelong and lifewide learning are the norm and that the tendency for compartmentalisation and institutionalisation of knowledge and learning may be constraining the benefits that individual, group and social learning can bring. The evidence for this is explored, and consideration given to how the aquaculture sector can unlock greater potential from its human capital. Reference is made to case studies, current initiatives and new collaborative platforms within the sector.info:eu-repo/semantics/publishedVersio

Mission vs. Market: Theorizing the Tensions within Community Sport Trusts

With the withdrawal of the state from local sport provision in the UK, Community Sport Trusts (CSTs) have grown significantly. The growth of CSTs is a direct outcome of neoliberal and austerity policy contexts in the UK. Research on the commodification of services delivered by hybrid social organizations suggests tensions between mission and market (internal purpose versus external control). Yet little research to date has been conducted on CSTs, with even less research that takes a critical approach. We seek to begin to consider this research gap by theorizing the problem, by looking at the tensions in hybridity, social mission, enterprise objectives, and financial sustainability of CSTs. We approach this by theory building from an examination of multidisciplinary literature; community sport, non-profit management, social enterprise, and social accounting literature to arrive at a conceptual model. This model contributes to knowledge by identifying and drawing out the tensions at play. We call for further theoretical and empirical research on CSTs that problematizes the “social” and draws attention to the inherent tensions in these hybrid business models, which are both academically under-explored and crucial to the success of a policy context where CSTs play a significant and expanding role in community sport delivery

Scabies outbreaks in ten care homes for elderly people: a prospective study of clinical features, epidemiology, and treatment outcomes

Background Scabies outbreaks in residential and nursing care homes for elderly people are common, subject to diagnostic delay, and hard to control. We studied clinical features, epidemiology, and outcomes of outbreaks in the UK between 2014 and 2015. Methods We did a prospective observational study in residential care homes for elderly people in southeast England that reported scabies outbreaks to Public Health England health protection teams. An outbreak was defined as two or more cases of scabies (in either residents or staff) at a single care home. All patients who provided informed consent were included; patients with dementia were included if a personal or nominated consultee (ie, a family member or nominated staff member) endorsed participation. Dermatology-trained physicians examined residents at initial clinical visits, which were followed by two mass treatments with topical scabicide as per local health protection team guidance. Follow-up clinical visits were held 6 weeks after initial visits. Scabies was diagnosed through pre-defined case definitions as definite, probable, or possible with dermatoscopy and microscopy as appropriate. Findings 230 residents were examined in ten outbreaks between Jan 23, 2014, and April 13, 2015. Median age was 86·9 years (IQR 81·5–92·3), 174 (76%) were female, and 157 (68%) had dementia. 61 (27%) residents were diagnosed with definite, probable, or possible scabies, of whom three had crusted scabies. Physical signs differed substantially from classic presentations. 31 (51%) of the 61 people diagnosed with scabies were asymptomatic, and only 25 (41%) had burrows. Mites were visualised with dermatoscopy in seven (11%) patients, and further confirmed by microscopy in three (5%). 35 (57%) cases had signs of scabies only on areas of the body that would normally be covered. Dementia was the only risk factor for a scabies diagnosis that we identified (odds ratio 2·37 [95% CI 1·38–4·07]). At clinical follow-up, 50 people who were initially diagnosed with scabies were examined. No new cases of scabies were detected, but infestation persisted in ten people. Interpretation Clinical presentation of scabies in elderly residents of care homes differs from classic descriptions familiar to clinicians. This difference probably contributes to delayed recognition and suboptimal management in this vulnerable group. Dermatoscopy and microscopy were of little value. Health-care workers should be aware of the different presentation of scabies in elderly people, and should do thorough examinations, particularly in people with dementia. Funding Public Health England and British Skin Foundation

Innovation in aquaculture teaching and learning

This report has been prepared by the Workpackage 5 working group on innovation in learning. It aims to summarise the main findings of the group, and serve as an introduction to the topic for teachers and learners in aquaculture and aquatic resources management. The main focus of the group is the use of Information and Communications Technologies (ICT) in teaching and learning. The increasing power of computers and particularly their interconnections through the Internet, is changing the social and economic landscape and presenting new opportunities and challenges for learners, educators and academic institutions. This document has been developed from presentations and discussions between the group members. It aims to identify the key technologies and trends affecting higher education in Europe and potential responses by the aquaculture and aquatic resource community. The aim is to briefly introduce key themes, technologies and state of the art. Most of the topics can be explored in much greater detail through the Internet links that are provided at the end of each section

Mania associated with herbal medicines, other than Cannabis: a systematic review and quality assessment of case reports

Background: DSM-5 introduced the diagnostic category of substance/medication-induced bipolar and related disorder. This systematic review examines published reports linking mania with the consumption of herbal medicines (HM), excluding cannabis. Putative pathophysiological mechanisms that may account for the reported HM being associated with mania are discussed.Methods: A systematic search of EMBASE, CINAHL, Health Source, PsychINFO, and PubMed. The quality of case reports meeting inclusion criteria was assessed using the modified Quality Assessment Scale by Agbabiaka.Results: Nineteen single and seven multiple-case reports met inclusion criteria. These yielded a study sample of 35 case reports, 28 of herbal medicine associated mania, 5 of hypomania, and two mixed states, in 17 females [age in years M(SD) = 43.1(13.2)] and 18 males [40.7(18.1)]. A total of 11 herbal medicines were implicated. Case reports by herbal medicine (number of reports) comprised: St John's wort (Hypericum perforatum) (14); Ginseng (Panax ginseng) (5); brindleberry (Garcinia cambogia) (4); ma-huang (Ephedra sinica) (3); “herbal slimming pills” (2); Herbalife products (2); Hydroxycut (1); horny goat weed (Epimedium grandiflorum) (1); “herbal body tonic” (1); celery root (Apium graveolans) (1), and a “herbal mixture” (1). All case reports were associated with use rather than withdrawal of herbal medicines. Only one case report was rated for probability of association using a standardized algorithm. Laboratory assays to confirm composition of the herbal preparation were reported in only one article describing two cases and indicating admixture of a likely causal pharmaceutical in the herbal preparation.Conclusions: Causal attributions are problematic given the limited number of reports, antidepressant co-prescribing in 7 cases, insufficient data regarding pattern and type of herbal medicine use, and lack of a reference frequency for spontaneous mania.The quality assessment scores across the 26 papers (35 case reports) were as follows: low quality (0), lower-medium quality (9), upper-medium quality (10) and high quality (7). Putative pathophysiological mechanisms were postulated for nine of the 11 herbal medicines and centered on HPA-axis activation and increased monoamine activity. Systematic study of the association between herbal medicines and the course of bipolar disorder may contribute to defining targets for pathophysiological research

Infection control behavior at home during the COVID-19 pandemic: observational study of a web-based behavioral intervention (Germ defence)

Background: To control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors. Objective: This study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved. Methods: This was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors. Results: Current behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31). Conclusions: Self-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission