Aphasia United - A Unified Voice for Aphasia

Aphasia United is a new peak international organization that aims to bring together the global aphasia community and represent its voice to the World Stroke Organization. The aim of this paper is to describe the processes of development and the strategic direction of Aphasia United, and its proposed process for developing an international research agenda. Initial discussions and a summit have prioritized capacity building of consumer organization, building consensus around best practice, raising awareness and creating a governance structure as well as developing an international research agenda for aphasia. Opportunities for involvement are outlined

Poems

The right life I am my beloveds and my beloved is mine Angles of repose This morning Migration In a sea fog Penguins For comrades in solitary confinement Greater flamingoes snipe Oystercatcher One sooty falcon Lesser kestrel Two ravens The nest in tatters That pair of pigeons Over a cup of tea And gathering of swallows twitter The speech of birds Early morning May Bird brigade

Can changing the timing of outdoor air intake reduce indoor concentrations of traffic-related pollutants in schools?

Traffic emissions have been associated with a wide range of adverse health effects. Many schools are situated close to major roads, and as children spend much of their day in school, methods to reduce traffic-related air pollutant concentrations in the school environment are warranted. One promising method to reduce pollutant concentrations in schools is to alter the timing of the ventilation so that high ventilation time periods do not correspond to rush hour traffic. Health Canada, in collaboration with the Ottawa-Carleton District School Board, tested the effect of this action by collecting traffic-related air pollution data from four schools in Ottawa, Canada, during October and November 2013. A baseline and intervention period was assessed in each school. There were statistically significant (P \u3c 0.05) reductions in concentrations of most of the pollutants measured at the two late-start (9 AM start) schools, after adjusting for outdoor concentrations and the absolute indoor–outdoor temperature difference. The intervention at the early-start (8 AM start) schools did not have significant reductions in pollutant concentrations. Based on these findings, changing the timing of the ventilation may be a cost-effective mechanism of reducing traffic-related pollutants in late-start schools located near major roads. © 2015 Her Majesty the Queen in Right of Canada. Indoor Air published by John Wiley & Sons Ltd. Reproduced with the permission of the Minister of Health Canada

Long-term follow-up of renal function in patients treated with migalastat for Fabry disease

The effect of migalastat on long-term renal outcomes in enzyme replacement therapy (ERT)-naive and ERT-experienced patients with Fabry disease is not well defined. An integrated posthoc analysis of the phase 3 clinical trials and open-label extension studies was conducted to evaluate long-term changes in renal function in patients with Fabry disease and amenable GLA variants who were treated with migalastat for ≥2 years during these studies. The analysis included ERT-naive (n = 36 [23 females]; mean age 45 years; mean baseline estimated glomerular filtration rate (eGFR), 91.4 mL/min/mL/1.73 m 2) and ERT-experienced (n = 42 [24 females]; mean age, 50 years; mean baseline eGFR, 89.2 mL/min/1.73m 2) patients with amenable variants who received migalastat 123 mg every other day for ≥2 years. The annualized rate of change from baseline to last observation in estimated glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation (eGFR) was calculated by both simple linear regression and a random coefficient model. In ERT-naive patients, mean annualized rates of change from baseline in eGFR were − 1.6 mL/min/1.73 m 2 overall and − 1.8 mL/min/1.73 m 2 and − 1.4 mL/min/1.73 m 2 in male and female patients, respectively, as estimated by simple linear regression. In ERT-experienced patients, mean annualized rates of change from baseline in eGFR were − 1.6 mL/min/1.73 m 2 overall and − 2.6 mL/min/1.73 m 2 and − 0.8 mL/min/1.73 m 2 in male and female patients, respectively. Mean annualized rate of change in eGFR in ERT-naive patients with the classic phenotype (defined by white blood cell alpha galactosidase A [α-Gal A] activity of <3% of normal and multiorgan system involvement) was −1.7 mL/min/1.73 m 2. When calculated using the random coefficient model, which adjusted for sex, age, and baseline renal function, the annualized eGFR change was minimal (mean: −0.1 and 0.1 mL/min/1.73 m 2 in ERT-naive and ERT-experienced patients, respectively). In conclusion, patients with Fabry disease and amenable GLA variants receiving long-term migalastat treatment (≤8.6 years) maintained renal function irrespective of treatment status, sex, or phenotype

Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF

PURPOSE: To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. METHODS: The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important treatment outcomes from aphasia rehabilitation. People with aphasia identified outcomes for themselves; and family members identified outcomes for themselves and for the person with aphasia. Outcomes were analysed using qualitative content analysis and ICF linking. RESULTS: A total of 39 people with aphasia and 29 family members participated in one of 16 nominal groups. Inductive qualitative content analysis revealed the following six themes: (1) Improved communication; (2) Increased life participation; (3) Changed attitudes through increased awareness and education about aphasia; (4) Recovered normality; (5) Improved physical and emotional well-being; and (6) Improved health (and support) services. Prioritized outcomes for both participant groups linked to all ICF components; primary activity/participation (39%) and body functions (36%) for people with aphasia, and activity/participation (49%) and environmental factors (28%) for family members. Outcomes prioritized by family members relating to the person with aphasia, primarily linked to body functions (60%). CONCLUSIONS: People with aphasia and their families identified treatment outcomes which span all components of the ICF. This has implications for research outcome measurement and clinical service provision which currently focuses on the measurement of body function outcomes. The wide range of desired outcomes generated by both people with aphasia and their family members, highlights the importance of collaborative goal setting within a family-centred approach to rehabilitation. These results will be combined with other stakeholder perspectives to establish a core outcome set for aphasia treatment research. Implications for Rehabilitation Important outcomes for people with aphasia and their families span all components of the ICF. The relevancy and translation of research findings may be increased by measuring and reporting research outcomes which are important to people living with aphasia. The results of this study indicate that important treatment outcomes for people living with aphasia most frequently link to the activity/participation and body function components of the ICF. The outcomes identified in this study suggest a broad role for clinicians working in aphasia rehabilitation. The categories of identified outcomes may be used clinically as a starting point in goal-setting discussions with clients and their families

Exploring Variation and Predictors of Residential Fine Particulate Matter Infiltration

Although individuals spend the majority of their time indoors, most epidemiological studies estimate personal air pollution exposures based on outdoor levels. This almost certainly results in exposure misclassification as pollutant infiltration varies between homes. However, it is often not possible to collect detailed measures of infiltration for individual homes in large-scale epidemiological studies and thus there is currently a need to develop models that can be used to predict these values. To address this need, we examined infiltration of fine particulate matter (PM2.5) and identified determinants of infiltration for 46 residential homes in Toronto, Canada. Infiltration was estimated using the indoor/outdoor sulphur ratio and information on hypothesized predictors of infiltration were collected using questionnaires and publicly available databases. Multiple linear regression was used to develop the models. Mean infiltration was 0.52 ± 0.21 with no significant difference across heating and non-heating seasons. Predictors of infiltration were air exchange, presence of central air conditioning, and forced air heating. These variables accounted for 38% of the variability in infiltration. Without air exchange, the model accounted for 26% of the variability. Effective modelling of infiltration in individual homes remains difficult, although key variables such as use of central air conditioning show potential as an easily attainable indicator of infiltration

Leaf level emissions of volatile organic compounds (VOC) from some Amazonian and Mediterranean plants

Emission inventories defining regional and global biogenic volatile organic compounds (VOC) emission strengths are needed to determine the impact of VOC on atmospheric chemistry (oxidative capacity) and physics (secondary organic aerosol formation and effects). The aim of this work was to contribute with measurements of tree species from the poorly described tropical vegetation in direct comparison with the quite well-investigated, highly heterogeneous emissions from Mediterranean vegetation. VOC emission from sixteen plant species from the Mediterranean area were compared with twelve plant species from different environments of the Amazon basin by an emission screening at leaf level using branch enclosures. Analysis of the volatile organics was performed online by a proton-transfer-reaction mass spectrometer (PTR-MS) and offline by collection on adsorbent tubes and subsequent gas chromatographic analysis. Isoprene was the most dominant compound emitted followed by monoterpenes, methanol and acetone. The average loss rates of VOC carbon in relation to the net CO2 assimilation were found below 4% and indicating normal unstressed plant behavior. Most of the Mediterranean species emitted a large variety of monoterpenes, whereas only five tropical species were identified as monoterpene emitters exhibiting a quite conservative emission pattern (&alpha;-pinene < limonene < sabinene < ß-pinene). Mediterranean plants showed additional emissions of sesquiterpenes. In the case of Amazonian plants no sesquiterpenes were detected. However, missing of sesquiterpenes may also be due to a lack of sensitivity of the measuring systems. Furthermore, our screening activities cover only 1% of tree species of such tropical areas as estimated based on recent biodiversity reports. Methanol emissions, an indicator of growth, were found to be common in most of the tropical and Mediterranean species. A few species from both ecosystems showed acetone emissions. The observed heterogeneous emissions, including reactive VOC species which are not easily detected by flux measurements, give reason to perform more screening at leaf level and, whenever possible, within the forests under ambient conditions. © 2013 Author(s)