The development and implementation of a strategic role within Scottish Enterprise

In all the discussion which has surrounded the establishment of Scottish Enterprise (SE) over the past two years, relatively little public attention has been given to the desired strategic direction in which the organisation could, or should, develop as it moves from the extended preparation phase into implementation. This paper commences with an examination of the strategy formulation process within this initiative and thereafter considers some of the determinants of Scottish Enterprise strategy against the background of the actual and prospective needs of the Scottish economy over the next five years or so

Scottish Enterprise : the basis of a Scottish solution to Scottish problems?

The Prime Minister's speech to the CBI in Scotland in September 1988 heralded the start of the most radical change in Government policy towards the sponsorship of economic development in Scotland for a generation. Like many such changes it commenced with much noise and little that was in any way cerebral. Of course, many radical policy changes do not stem from an in-depth analysis of the issues and the options, and this was no exception. Since that date, the due process of debate and consultation have been conducted with more heat than light, but with no little trauma for the two merging bodies namely the Scottish Development Agency (SDA) and the Training Agency (TA), as they have endeavoured to continue to fulfil their responsibilities. That they have managed to do so effectively is no small tribute to the commitment of those working in these organisations as they move towards the end of the thirty one month process leading to the final emergence of Scottish Enterprise in April 1991. This paper attempts to stand back from these changes and reflect on some of their characteristics and implications. It is written from the perspective of someone closely involved in the process of taking the concept (1) and helping to shape it in a way which would be to the benefit of the Scottish economy

Altered Cerebrospinal Fluid Clearance and Increased Intracranial Pressure in Rats 18 h After Experimental Cortical Ischaemia

Oedema-independent intracranial pressure (ICP) rise peaks 20–22-h post-stroke in rats and may explain early neurological deterioration. Cerebrospinal fluid (CSF) volume changes may be involved. Cranial CSF clearance primarily occurs via the cervical lymphatics and movement into the spinal portion of the cranio-spinal compartment. We explored whether impaired CSF clearance at these sites could explain ICP rise after stroke. We recorded ICP at baseline and 18-h post-stroke, when we expect changes contributing to peak ICP to be present. CSF clearance was assessed in rats receiving photothrombotic stroke or sham surgery by intraventricular tracer infusion. Tracer concentration was quantified in the deep cervical lymph nodes ex vivo and tracer transit to the spinal subarachnoid space was imaged in vivo. ICP rose significantly from baseline to 18-h post-stroke in stroke vs. sham rats [median = 5 mmHg, interquartile range (IQR) = 0.1–9.43, n = 12, vs. −0.3 mmHg, IQR = −1.9–1.7, n = 10], p = 0.03. There was a bimodal distribution of rats with and without ICP rise. Tracer in the deep cervical lymph nodes was significantly lower in stroke with ICP rise (0 μg/mL, IQR = 0–0.11) and without ICP rise (0 μg/mL, IQR = 0–4.47) compared with sham rats (4.17 μg/mL, IQR = 0.74–8.51), p = 0.02. ICP rise was inversely correlated with faster CSF transit to the spinal subarachnoid space (R = −0.59, p = 0.006, Spearman’s correlation). These data suggest that reduced cranial clearance of CSF via cervical lymphatics may contribute to post-stroke ICP rise, partially compensated via increased spinal CSF outflow

Changes in immune cell populations in the periphery and liver of GBV-B-infected and convalescent tamarins (Saguinus labiatus)

AbstractFlaviviruses related to hepatitis C virus (HCV) in suitable animal models may provide further insight into the role that cellular immunity contributes to spontaneous clearance of HCV. We characterised changes in lymphocyte populations in tamarins with an acute GBV-B infection, a hepatitis virus of the flaviviridae. Major immune cell populations were monitored in peripheral and intra-hepatic lymphocytes at high viraemia or following a period when peripheral virus was no longer detected. Limited changes in major lymphocyte populations were apparent during high viraemia; however, the proportions of CD3+ lymphocytes decreased and CD20+ lymphocytes increased once peripheral viraemia became undetectable. Intrahepatic lymphocyte populations increased at both time points post-infection. Distinct expression patterns of PD-1, a marker of T-cell activation, were observed on peripheral and hepatic lymphocytes; notably there was elevated PD-1 expression on hepatic CD4+ T-cells during high viraemia, suggesting an activated phenotype, which decreased following clearance of peripheral viraemia. At times when peripheral vRNA was not detected, suggesting viral clearance, we were able to readily detect GBV-B RNA in the liver, indicative of long-term virus replication. This study is the first description of changes in lymphocyte populations during GBV-B infection of tamarins and provides a foundation for more detailed investigations of the responses that contribute to the control of GBV-B infection

Heptanoate is neuroprotective in vitro but triheptanoin post-treatment did not protect against middle cerebral artery occlusion in rats

Triheptanoin, the medium-chain triglyceride of heptanoate, has been shown to be anticonvulsant and neuroprotective in several neurological disorders. In the gastrointestinal tract, triheptanoin is cleaved to heptanoate, which is then taken up by the blood and most tissues, including liver, heart and brain. Here we evaluated the neuroprotective effects of heptanoate and its effects on mitochondrial oxygen consumption in vitro. We also investigated the neuroprotective effects of triheptanoin compared to long-chain triglycerides when administered after stroke onset in rats. Heptanoate pre-treatment protected cultured neurons against cell death induced by oxygen glucose deprivation and N-methyl-D-aspartate. Incubation of cultured astrocytes with heptanoate for 2 h increased mitochondrial proton leak and also enhanced basal respiration and ATP turnover, suggesting that heptanoate protects against oxidative stress and is used as fuel. However, continuous 72 h infusion of triheptanoin initiated 1 h after middle cerebral artery occlusion in rats did not alter stroke volume at 3 days or neurological deficit at 1 and 3 days relative to long-chain triglyceride control treatment

Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review

Background Globally, people with intellectual disabilities, autism, or both, experience health inequalities. Death occurs at a younger age and the prevalence of long-term morbidities is higher than in the general population. Despite this, their primary healthcare access rates are lower, their health needs are often unmet, and their views and experiences are frequently overlooked in research, policy and practice. Aim To investigate the barriers and facilitators reported by individuals with intellectual disabilities, autism or both, and / or their carers, to accessing and utilising primary healthcare for their physical and mental health needs. Design and setting An integrative review utilising systematic review methodology. (PROSPERO: CRD42018103103). Method Electronic databases MEDLINE, Embase, CINAHL and Cochrane were searched for relevant studies (all languages) using a search strategy. Two researchers independently screened the results and assessed the quality of studies. Results Sixty-three international studies were identified. Six main themes relating to barriers and facilitators emerged from an analysis of these studies. The themes included training; knowledge and awareness; communication; fear and embarrassment; involvement in healthcare decision-making; and time. All the themes were underpinned by the need for greater care, dignity, respect, collaborative relationships and the need for reasonable adjustments. Opposing barriers and facilitators were identified within each of the main themes. Conclusions Adolescents and adults with intellectual disabilities, autism, or both, experience several barriers to accessing and utilising primary healthcare. The findings highlight the reasonable adjustments and facilitators that can be implemented to ensure that these individuals are not excluded from primary healthcare. How this fits in? This review synthesises evidence on the barriers and facilitators to accessing and utilising primary healthcare perceived by people with intellectual disabilities, autism or both. The findings highlight important considerations for primary healthcare policy, practice and further research