Development of a patient reported outcome measure for fatigue in motor neurone disease: the Neurological Fatigue Index (NFI-MND).

BACKGROUND: The objective of this research was to develop a disease-specific measure for fatigue in patients with motor neurone disease (MND) by generating data that would fit the Rasch measurement model. Fatigue was defined as reversible motor weakness and whole-body tiredness that was predominantly brought on by muscular exertion and was partially relieved by rest. METHODS: Qualitative interviews were undertaken to confirm the suitability of a previously identified set of 52 neurological fatigue items as relevant to patients with MND. Patients were recruited from five U.K. MND clinics. Questionnaires were administered during clinic or by post. A sub-sample of patients completed the questionnaire again after 2-4 weeks to assess test-retest validity. Exploratory factor analyses and Rasch analysis were conducted on the item set. RESULTS: Qualitative interviews with ten MND patients confirmed the suitability of 52 previously identified neurological fatigue items as relevant to patients with MND. 298 patients consented to completing the initial questionnaire including this item set, with an additional 78 patients completing the questionnaire a second time after 4-6 weeks. Exploratory Factor Analysis identified five potential subscales that could be conceptualised as representing: 'Energy', 'Reversible muscular weakness' (shortened to 'Weakness'), 'Concentration', 'Effects of heat' and 'Rest'. Of the original five factors, two factors 'Energy' and 'Weakness' met the expectations of the Rasch model. A higher order fatigue summary scale, consisting of items from the 'Energy' and 'Weakness' subscales, was found to fit the Rasch model and have acceptable unidimensionality. The two scales and the higher order summary scale were shown to fulfil model expectations, including assumptions of unidimensionality, local independency and an absence of differential item functioning. CONCLUSIONS: The Neurological Fatigue Index for MND (NFI-MND) is a simple, easy-to-administer fatigue scale. It consists of an 8-item fatigue summary scale in addition to separate scales for measuring fatigue experienced as reversible muscular weakness and fatigue expressed as feelings of low energy and whole body tiredness. The underlying two factor structure supports the patient concept of fatigue derived from qualitative interviews in this population. All three scales were shown to be reliable and capable of interval level measurement

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Decontamination of some urban surfaces

SIGLEAvailable from British Library Document Supply Centre- DSC:1769.7F(CEGB/TPRD/B--1064/R88)fiche / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The ecology of the European badger (Meles meles) in Ireland: a review

peer-reviewedThe badger is an ecologically and economically important species. Detailed knowledge of aspects of the ecology of this animal in Ireland has only emerged through research over recent decades. Here, we review what is known about the species' Irish populations and compare these findings with populations in Britain and Europe. Like populations elsewhere, setts are preferentially constructed on south or southeast facing sloping ground in well-drained soil types. Unlike in Britain, Irish badger main setts are less complex and most commonly found in hedgerows. Badgers utilise many habitat types, but greater badger densities have been associated with landscapes with high proportions of pasture and broadleaf woodlands. Badgers in Ireland tend to have seasonally varied diets, with less dependence on earthworms than some other populations in northwest Europe. Recent research suggests that females exhibit later onset and timing of reproductive events, smaller litter sizes and lower loss of blastocysts than populations studied in Britain. Adult social groups in Ireland tend to be smaller than in Britain, though significantly larger than social groups from continental Europe. Although progress has been made in estimating the distribution and density of badger populations, national population estimates have varied widely in the Republic of Ireland. Future research should concentrate on filling gaps in our knowledge, including population models and predictive spatial modelling that will contribute to vaccine delivery, management and conservation strategies.Department of Agriculture, Fisheries and FoodTeagasc Walsh Fellowship Programm