Assessment of mood in aphasia following stroke: validation of the Dynamic Visual Analogue Mood Scales (D-VAMS)

OBJECTIVES: To validate a non-verbal self-report measure of mood - the Dynamic Visual Analogue Mood Scales (D-VAMS) - against the Hospital Anxiety and Depression Scale (HADS) and assess its suitability as an outcome measure or screening measure for depressed mood following stroke. DESIGN: Cross-sectional observational cohort study. PARTICIPANTS: Forty-six stroke survivors (24% with aphasia) recruited from online, from stroke clubs and via an NHS rehabilitation service. METHODS: A set of seven bipolar scales was developed enabling users to report mood by modifying facial expression images using a slider. Participants completed a tablet/computer task, reporting their mood on these scales mixed randomly with versions which used only words. The HADS was then completed, followed by a repeat run of the two versions in a different, random sequence. RESULTS: Exploratory factor analysis identified one factor consistent with pleasantness of mood accounting for 80% of the variance. Internal consistency of D-VAMS was high ( α = 0.95), and there was a high correlation between face-only D-VAMS scores and HADS total scores ( r = -0.80, P < 0.001), as well as HADS-D/HADS-A subscale scores ( r = -0.73, P < 0.001; r = -0.71, P < 0.001). D-VAMS showed good sensitivity and specificity against HADS, with means of 85%/77% (sensitivity/specificity) against the HADS-D and 80%/77% against the HADS-A across nine cut-offs. CONCLUSION: D-VAMS is a valid and reliable measure likely suitable for assessment of depressed mood in aphasia following stroke. Though D-VAMS performed well as a screening measure in this study sample, further study is needed in the acute stage post-stroke

Mapping urban greenspace use from mobile phone GPS data

Urban greenspace is a valuable component of the urban form that has the potential to improve the health and well-being of residents. Most quantitative studies of relationships between health and greenspace to date have investigated associations only with what greenspace exists in the local environment (i.e. provision of greenspace), rather than to what extent it is used. This is due to the difficulty of obtaining usage data in large amounts. In recent years, GPS functionality integrated into mobile phones has provided a potential solution to this problem by making it possible to track which parts of the environment people experience in their day-to-day lives. In this paper, we demonstrate a method to derive cleaned, trip-level information from raw GPS data collected by a mobile phone app, then use this data to investigate the characteristics of trips to urban greenspace by residents of the city of Sheffield, UK. We find that local users of the app spend an average of an hour per week visiting greenspaces, including around seven trips per week and covering a total distance of just over 2.5 km. This may be enough to provide health benefits, but is insufficient to provide maximal benefits. Trip characteristics vary with user demographics: ethnic minority users and users from more socioeconomically deprived areas tend to make shorter trips than White users and those from less deprived areas, while users aged 34 years and over make longer trips than younger users. Women, on average, make more frequent trips than men, as do those who spent more time outside as a child. Our results suggest that most day-to-day greenspace visits are incidental, i.e. travelling through rather than to greenspace, and highlight the importance of including social and cultural factors when investigating who uses and who benefits from urban greenspace.Natural Environment Research Counci

Smoke, curtains and mirrors: the production of race through time and title registration

This article analyses the temporal effects of title registration and their relationship to race. It traces the move away from the retrospection of pre-registry common law conveyancing and toward the dynamic, future-oriented Torrens title registration system. The Torrens system, developed in early colonial Australia, enabled the production of ‘clean’, fresh titles that were independent of their predecessors. Through a process praised by legal commentators for ‘curing’ titles of their pasts, this system produces indefeasible titles behind its distinctive ‘curtain’ and ‘mirror’, which function similarly to magicians’ smoke and mirrors by blocking particular realities from view. In the case of title registries, those realities are particular histories of and relationships with land, which will not be protected by property law and are thus made precarious. Building on interdisciplinary work which theorises time as a social tool, I argue that Torrens title registration produces a temporal order which enables land market coordination by rendering some relationships with land temporary and making others indefeasible. This ordering of relationships with land in turn has consequences for the human subjects who have those relationships, cutting futures short for some and guaranteeing permanence to others. Engaging with Renisa Mawani and other critical race theorists, I argue that the categories produced by Torrens title registration systems materialise as race

Increasing Dietary Fat Elicits Similar Changes in Fat Oxidation and Markers of Muscle Oxidative Capacity in Lean and Obese Humans

In lean humans, increasing dietary fat intake causes an increase in whole-body fat oxidation and changes in genes that regulate fat oxidation in skeletal muscle, but whether this occurs in obese humans is not known. We compared changes in whole-body fat oxidation and markers of muscle oxidative capacity differ in lean (LN) and obese (OB) adults exposed to a 2-day high-fat (HF) diet. Ten LN (BMI = 22.5±2.5 kg/m2, age = 30±8 yrs) and nine OB (BMI = 35.9±4.93 kg/m2, 38±5 yrs, Mean±SD) were studied in a room calorimeter for 24hr while consuming isocaloric low-fat (LF, 20% of energy) and HF (50% of energy) diets. A muscle biopsy was obtained the next morning following an overnight fast. 24h respiratory quotient (RQ) did not significantly differ between groups (LN: 0.91±0.01; OB: 0.92±0.01) during LF, and similarly decreased during HF in LN (0.86±0.01) and OB (0.85±0.01). The expression of pyruvate dehydrogenase kinase 4 (PDK4) and the fatty acid transporter CD36 increased in both LN and OB during HF. No other changes in mRNA or protein were observed. However, in both LN and OB, the amounts of acetylated peroxisome proliferator-activated receptor γ coactivator-1-α (PGC1-α) significantly decreased and phosphorylated 5-AMP-activated protein kinase (AMPK) significantly increased. In response to an isoenergetic increase in dietary fat, whole-body fat oxidation similarly increases in LN and OB, in association with a shift towards oxidative metabolism in skeletal muscle, suggesting that the ability to adapt to an acute increase in dietary fat is not impaired in obesity

Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda

Abstract Background: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. Methods: The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. Results: In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. Conclusion: The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals

Computational Assessment Of Thioether Isosteres

Replacement of the sulfur atom in biologically active diaryl and heteroaryl thioethers (Ar–S–Ar’, HAr–S–Ar, and HAr–S–HAr’) with any of several one-atom or two-atom linkers can be expected to reduce the susceptibility of the analogue to metabolic oxidation, a well-documented problem for thioethers intended for medicinal chemistry applications. Ab initio calculations indicate how well various proposed thioether isosteric groups, including some new and unusual ones, may perform structurally and electronically in replacing the bridging sulfur atom. Four of these are calculationally evaluated as proposed substructures in Axitinib analogues. The predicted binding behavior of the latter within two different previously crystallographically characterized protein-Axitinib binding sites (VEGFR2 kinase and ABL1 T315I gatekeeper mutant kinase), and an assessment of their suitability and anticipated shortcomings, are presented

Effect of dietary ascorbic acid vitamin supplements on growth and survival of striped bass, Morone saxatilis, and inland silverside, Menidia beryllina, larvae

Larvae of striped bass (12 d old) and silversides (14 d old) were fed for 4 weeks on marumerized diets containing 100 mg/kg ascorbic acid equivalency as ascorbic acid-2-sulfate (AS-2-SO4), ethylcellulose coated ascorbic acid (ECAA), ascorbic acid-2-polyphosphate (Stay-C; ST-C), and ascorbic acid-2-monophosphatc (MPO4). Survival and growth of the fish were compared with those of fish fed a control diet with no supplemental ascorbic acid (30 mg/kg background level only) and fish fed exclusively on live Anemia nauplii. Live nauplii yielded better growth and survival for both species. Striped bass survival rates ranged from 33 to 47% for all the ascorbic acid diets, including the control, except that survival on the AS-2-SO4 was significantly (P\u3c0.05) less than rest of the dietary treatments. No growth differences were detected among the ascorbic acid diets but growth on all the diets was significantly lower than that of fish fed on live Anemia nauplii. Silverside larvae exhibited no growth or survival differences among any ascorbic acid supplemented, diet without ascorbic acid diets, nor between those diets and live food. The results indicate that all the ascorbic acid vitamers except AS-2-SO4 can be used as an alternate source of vitamin C for striped bass and inland silvcrsides larvae. These studies further indicate that larval stages of these two fish species do not require ascorbic acid supplementation when raised/cultured on practical diets

Stereoelectronic Features of a Complex Ketene Dimerization Reaction

The amidation reaction of a tetrahydroisoquinolin-1-one-4-carboxylic acid is a key step in the multi-kilogram-scale preparation of the antimalarial drug SJ733, now in phase 2 clinical trials. In the course of investigating THIQ carboxamidations, we found that propanephosphonic acid anhydride (T3P) is an effective reagent, although the yield and byproducts vary with the nature and quantity of the base. As a control, the T3P reaction of a 3-(2-thienyl) THIQ was performed in the absence of the amine, and the products were characterized: among them are three dimeric allenes and two dimeric lactones. A nucleophile-promoted ketene dimerization process subject to subtle steric and stereoelectronic effects accounts for their formation. Two novel monomeric products, a decarboxylated isoquinolone and a purple, fused aryl ketone, were also isolated, and mechanisms for their formation from the ketene intermediate are proposed