The neural basis of external responsiveness in prolonged disorders of consciousness

Objective: To investigate the structural integrity of fibre tracts underlying overt motor behaviour in PDOC. Methods: This cross-sectional study examined 15 PDOC patients and 22 healthy participants. Eight PDOC patients met the criteria for the vegetative state, 5 met the criteria for the minimally conscious state and 2 met the criteria for emerging from the minimally conscious state. We used fibre tractography to reconstruct the white matter fibres known to be involved in voluntary motor execution (i.e., those connecting thalamus with M1, M1 with cerebellum, and cerebellum with thalamus) and used fractional anisotropy (FA) as a measure of their integrity. Results: PDOC patients showed significantly reduced FA relative to controls on the fibres connecting thalamus and M1. This went above and beyond a widespread injury to the white matter and correlated with clinical severity. In a subset of patients, we also identified a similar pattern of injury in the fibres connecting M1 and cerebellum but a relative preservation of those connecting cerebellum and thalamus. Conclusions: Our results suggest that structural damage to motor fibres may lead to reduced responsiveness in PDOC patients across all diagnostic sub-categories, and therefore behavioural assessments may underestimate the level of retained cognitive function and awareness across the PDOC spectrum

Increased Psychological Distress during COVID-19 and Quarantine in Ireland: A national survey.

Background: The emergence of the coronavirus pneumonia (COVID-19) resulted in a global pandemic. The psychological impact of an epidemic is multifaceted and acute, with long-term consequences. Methods: A cross-sectional online survey-based design was employed, assessing the psychological impact of COVID-19 on members of the Irish public during the quarantine period of COVID-19 in Ireland. Participants were invited to complete the Depression, Anxiety, and Stress Scale-21 (DASS-21) retrospectively (prior to quarantine) and during the quarantine period, as well as measures of illness perceptions, well-being, and a bespoke measure (the Effects of COVID Questionnaire, ECQ), which assessed perceptions of COVID-related stresses associated with personal concerns, caring for children, caring for aging parents, as well as gratitude. Results: A total of n = 1620 entered the survey platform, with a total of n = 847 surveys completed by members of the Irish public. Entry into COVID-19 quarantine was associated with significant increases in clinically significant symptoms of depression, stress, and anxiety. The ECQ reliably assessed a range of COVID-19-related stresses and had large and significant correlations with the DASS-21. Conclusions: The COVID-19 quarantine was associated with stresses and significant increases in symptoms of depression, anxiety, and stress in a national Irish cohort. The public require increased access to mental health services to meet this increase in COVID-19-related psychological distress

Being Warm Being Happy: fuel poverty and adults with intellectual disabilities

Self-determination has been acknowledged as a criticalconstruct for people with intellectual disability (ID), given the benefits itspromotion entails towards an enhanced quality of life..

Impacts, adaptation and vulnerability to global environmental change: challenges and pathways for an action-oriented research agenda for middle-income and low-income countries

The socio-economic impacts of environmental stresses associated with global environmental change depend to a large extent on how societies organize themselves. Research on climate-related societal impacts, vulnerability and adaptation is currently underdeveloped, prompting international global environmental change research institutions to hold a series of meetings in 2009–2010. One of these aimed at identifying needs in middle-income and low-income countries (MLICs), and found that effective responses to the challenge of reducing vulnerability and enhancing adaptation will drive research and policy into challenging and innovative areas of research. Producing impacts, vulnerability and adaptation knowledge requires greater inclusion of MLIC researchers and a rethinking of the research structures, institutions and paradigms that have dominated global change research to date. Scientific literature discussed in this article suggests that governance issues need to become central objects of empirically based, detailed, multiscalar and action-oriented research, and that this needs to address the politically sensitive and seemingly intractable issue of reducing global inequities in power and resource distribution. The scientific literature suggests that without effective action in those directions, current trends toward greater inequality will continue to both reflect and intensify global environmental threats and their impacts

An integrated framework for sustainable development goals

The United Nations (UN) Rio+20 summit committed nations to develop a set of universal sustainable development goals (SDGs) to build on the millennium development goals (MDGs) set to expire in 2015. Research now indicates that humanity’s impact on Earth’s life support system is so great that further global environmental change risks undermining long-term prosperity and poverty eradication goals. Socioeconomic development and global sustainability are often posed as being in conflict because of trade-offs between a growing world population, as well as higher standards of living, and managing the effects of production and consumption on the global environment. We have established a framework for an evidence-based architecture for new goals and targets. Building on six SDGs, which integrate development and environmental considerations, we developed a comprehensive framework of goals and associated targets, which demonstrate that it is possible, and necessary, to develop integrated targets relating to food, energy, water, and ecosystem services goals; thus providing a neutral evidence-based approach to support SDG target discussions. Global analyses, using an integrated global target equation, are close to providing indicators for these targets. Alongside development-only targets and environment-only targets, these integrated targets would ensure that synergies are maximized and trade-offs are managed in the implementation of SDGs

Being warm being happy: understanding factors influencing adults with learning disabilities being warm and well at home with inclusive research

The aim of the Being Warm Being Happy project was to understand and characterise fuel poverty and energy vulnerability from the perspective of adults with learning disabilities. Undertaken in community settings in South Yorkshire, UK, the study adopted an inclusive research approach, with three members of a self-advocacy organisation who have learning disabilities and/or autism working alongside academics as co-researchers. The study incorporated home temperature and humidity measurements and qualitative individual interviews. Ten households, all of which included an adult with learning disabilities participated in the research. Framework analysis identified four interrelated themes influencing decisions about energy use and payment method. First, energy need varied according to health status. Energy need was also influenced by the size, tenure and age of the participant’s home. Second, emotions, attitudes and values, in particular a sense of control impacted upon energy use. Third, knowledge and previous experience could help or hinder participants keeping warm. Factors included prior first-hand experiences of support from self-advocacy organisations, energy companies and local authorities and the influence of parents’ views and practices. Finally, concerns about affordability and challenges accessing the energy market also had an important impact on experiences and decisions. The research contributes to the limited evidence base about the nature and experience of fuel poverty amongst adults with learning disabilities highlighting the extent to which the existing energy system puts them at a disadvantage and the resourcefulness and resilience of many adults with learning disabilities when facing these challenges

Large UK retailers' initiatives to reduce consumers' emissions: a systematic assessment

In the interest of climate change mitigation, policy makers, businesses and non-governmental organisations have devised initiatives designed to reduce in-use emissions whilst, at the same time, the number of energy-consuming products in homes, and household energy consumption, is increasing. Retailers are important because they are at the interface between manufacturers of products and consumers and they supply the vast majority of consumer goods in developed countries like the UK, including energy using products. Large retailers have a consistent history of corporate responsibility reporting and have included plans and actions to influence consumer emissions within them. This paper adapts two frameworks to use them for systematically assessing large retailers’ initiatives aimed at reducing consumers’ carbon emissions. The Framework for Strategic Sustainable Development (FSSD) is adapted and used to analyse the strategic scope and coherence of these initiatives in relation to the businesses’ sustainability strategies. The ISM ‘Individual Social Material’ framework is adapted and used to analyse how consumer behaviour change mechanisms are framed by retailers. These frameworks are used to analyse eighteen initiatives designed to reduce consumer emissions from eight of the largest UK retail businesses, identified from publicly available data. The results of the eighteen initiatives analysed show that the vast majority were not well planned nor were they strategically coherent. Secondly, most of these specific initiatives relied solely on providing information to consumers and thus deployed a rather narrow range of consumer behaviour change mechanisms. The research concludes that leaders of retail businesses and policy makers could use the FSSD to ensure processes, and measurements are comprehensive and integrated, in order to increase the materiality and impact of their initiatives to reduce consumer emissions in use. Furthermore, retailers could benefit from exploring different models of behaviour change from the ISM framework in order to access a wider set of tools for transformative system change

Writing in Britain and Ireland, c. 400 to c. 800

No abstract available

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy