Vulnerability and Post-Stroke Experiences of Working-Age Survivors During Recovery

Survivors who experience stroke of mild to moderate severity are typically discharged home quickly, with only minimal referral for rehabilitation follow-up or support to meet specific needs in recovery. Particular vulnerabilities of younger, higher functioning stroke survivors have received some recognition in international literature in recent years. This article reports on findings of a small Australian qualitative study focusing on recovery and return to work experiences of young higher functioning female stroke survivors, in particular exploring experiences of post-stroke vulnerability from participants’ own perspectives. Our research adds depth and nuance to this developing area of interest and research. Our findings include survivors’ reflections on the consequences of delayed diagnosis, the impacts of empowering and disempowering interactions with health care professionals, a general lack of access to psychosocial rehabilitation, and frustrations of financial hardship. Implications for health professionals, service systems, and income support provision are discussed, along with directions for future research

Phosphate Monoester Hydrolysis in Cyclohexane

The hydrolysis of simple phosphate monoesters is among the most difficult reactions that are subject to catalysis by enzymes, and it has been suggested that extraction of the substrates from solvent water may contribute to the catalytic effects of phosphohydrolases. Here, we show that the tetrabutylammonium salt of neopentyl phosphate enters wet cyclohexane at concentrations sufficient to allow determination of its rate of hydrolysis. The second-order rate constant for hydrolysis of the phosphomonoester dianion is enhanced approximately 2 x 10(12)-fold by transfer from water to cyclohexane. That rate enhancement arises from an increase in the entropy of activation

Trophic Conditions and Planktonic Processes of Semi-arid Floodplain Lakes Inundated with Environmental Flows

Shallow floodplain lakes are critical components of semi-arid floodplain wetland systems. Delivery of environmental flows that aim to sustain ecological processes of semi-arid floodplain wetlands has enhanced inundation of shallow lakes in inland Australia. To maximise environmental flow outcomes to support floodplain productivity and ecosystem functions, environmental managers would benefit from knowing whether semi-arid floodplain lakes function as a sink or source of atmospheric carbon. We investigated abiotic conditions, and rates of planktonic respiration and primary productivity of phytoplankton during summer under environmental flow conditions in three floodplain lakes of the lower Murrumbidgee River, Australia. All lakes showed mesoeutrophic to hypereutrophic characteristics and significant within- and between-lake variability in abiotic conditions, planktonic processes, and associated carbon balance. Nevertheless, the mean net primary productivity of phytoplankton in the lakes (364-1,674 mg C m-2 day-1) were up to about three times greater than in other semi-arid floodplain wetlands of southeast Australia. Therefore, shallow floodplain lakes in semi-arid regions have great potential to function as a sink of atmospheric carbon through planktonic metabolism during summer. A spatial hierarchical framework for lake functional response to inundation is proposed to support decision-making and to maximise the benefits of environmental flow regimes for floodplain lakes

The hydrolysis of phosphate diesters in cyclohexane and acetone

The hydrolysis of phosphate diesters is one of the most difficult reactions known. Here we show that in acetone or cyclohexane, at 25 °C, phosphodiesters undergo hydrolysis 5 × 105 and 2 × 109-fold more rapidly than in water, respectively, and that this rate enhancement is achieved by lowering the enthalpy of activation

Understanding implementation success: protocol for an in-depth, mixed-methods process evaluation of a cluster randomised controlled trial testing methods to improve detection of Lynch syndrome in Australian hospitals.

INTRODUCTION:In multisite intervention trials, implementation success often varies widely across settings. Process evaluations are crucial to interpreting trial outcomes and understanding contextual factors and causal chains necessary for successful implementation. Lynch syndrome is a hereditary cancer predisposition conferring an increased risk of colorectal, endometrial and other cancer types. Despite systematic screening protocols to identify Lynch syndrome, the condition remains largely underdiagnosed. The Hide and Seek Project ('HaSP') is a cluster randomised controlled trial determining the effectiveness of two approaches to improving Lynch syndrome detection at eight Australian hospital networks. To enhance widespread implementation of optimal Lynch syndrome identification, there is a need to understand not only what works, but also why, in what contexts, and at what costs. Here we describe an in-depth investigation of factors influencing successful implementation of procedures evaluated in the HaSP trial. METHODS AND ANALYSIS:A mixed-methods, theory-driven process evaluation will be undertaken in parallel to the HaSP trial. Data will include: interviews of Implementation Leads and Lynch syndrome stakeholders, pre-post implementation questionnaires, audio analysis of meetings and focus groups, observation of multidisciplinary team meetings, fidelity checklists and project log analysis. Results will be triangulated and coded, drawing on the Theoretical Domains Framework, Consolidated Framework for Implementation Research and Proctor's implementation outcomes. ETHICS AND DISSEMINATION:Use of a theory-based process evaluation will enhance interpretation and generalisability of HaSP trial findings, and contribute to the implementation research field by furthering understanding of the conditions necessary for implementation success. Ethical approval has been granted and results will be disseminated via publications in peer-reviewed journals and conference presentations. At trial completion, key findings will be fed back to sites to enable refinement of intervention strategies, both in the context of Lynch syndrome and for the possible generalisability of intervention components in other genetic and broader clinical specialties. HASP TRIAL REGISTRATION NUMBER:Australian New Zealand Clinical Trials Registry (Identifier: ACTRN12618001072202). Registered 27 June 2018. http://www.ANZCTR.org.au/ACTRN12618001072202.aspx

The rate of spontaneous cleavage of the glycosidic bond of adenosine

Previous estimates of the rate of spontaneous cleavage of the glycosidic bond of adenosine were determined by extrapolating the rates of the acid - and base-catalyzed reactions to neutral pH. Here we show that cleavage also proceeds through a pH-independent mechanism. Rate constants were determined as a function of temperature at pH 7 and a linear Arrhenius plot was constructed. Uncatalyzed cleavage occurs with a rate constant of 3.7 × 10−12 s−1 at 25 °C, and the rate enhancement generated by the corresponding glycoside hydrolase is ~5 × 1012-fold

Metropolis simulations of Met-Enkephalin with solvent-accessible area parameterizations

We investigate the solvent-accessible area method by means of Metropolis simulations of the brain peptide Met-Enkephalin at 300$K$. For the energy function ECEPP/2 nine atomic solvation parameter (ASP) sets are studied. The simulations are compared with one another, with simulations with a distance dependent electrostatic permittivity $\epsilon (r)$, and with vacuum simulations ($\epsilon =2$). Parallel tempering and the biased Metropolis techniques RM$_1$ are employed and their performance is evaluated. The measured observables include energy and dihedral probability densities (pds), integrated autocorrelation times, and acceptance rates. Two of the ASP sets turn out to be unsuitable for these simulations. For all other systems selected configurations are minimized in search of the global energy minima, which are found for the vacuum and the $\epsilon(r)$ system, but for none of the ASP models. Other observables show a remarkable dependence on the ASPs. In particular, we find three ASP sets for which the autocorrelations at 300$$K are considerably smaller than for vacuum simulations.Comment: 10 pages and 8 figure

Analysis of acoustic emission during the melting of embedded indium particles in an aluminum matrix: a study of plastic strain accommodation during phase transformation

Acoustic emission is used here to study melting and solidification of embedded indium particles in the size range of 0.2 to 3 um in diameter and to show that dislocation generation occurs in the aluminum matrix to accommodate a 2.5% volume change. The volume averaged acoustic energy produced by indium particle melting is similar to that reported for bainite formation upon continuous cooling. A mechanism of prismatic loop generation is proposed to accommodate the volume change and an upper limit to the geometrically necessary increase in dislocation density is calculated as 4.1 x 10^9 cm^-2 for the Al-17In alloy. Thermomechanical processing is also used to change the size and distribution of the indium particles within the aluminum matrix. Dislocation generation with accompanied acoustic emission occurs when the melting indium particles are associated with grain boundaries or upon solidification where the solid-liquid interfaces act as free surfaces to facilitate dislocation generation. Acoustic emission is not observed for indium particles that require super heating and exhibit elevated melting temperatures. The acoustic emission work corroborates previously proposed relaxation mechanisms from prior internal friction studies and that the superheat observed for melting of these micron-sized particles is a result of matrix constraint.Comment: Presented at "Atomistic Effects in Migrating Interphase Interfaces - Recent Progress and Future Study" TMS 201

Comparing theory and non-theory based implementation approaches to improving referral practices in cancer genetics: A cluster randomised trial protocol

© 2019 The Author(s). Background: Lynch syndrome (LS) is an inherited, cancer predisposition syndrome associated with an increased risk of colorectal, endometrial and other cancer types. Identifying individuals with LS allows access to cancer risk management strategies proven to reduce cancer incidence and improve survival. However, LS is underdiagnosed and genetic referral rates are poor. Improving LS referral is complex, and requires multisystem behaviour change. Although barriers have been identified, evidence-based strategies to facilitate behaviour change are lacking. The aim of this study is to compare the effectiveness of a theory-based implementation approach against a non-theory based approach for improving detection of LS amongst Australian patients with colorectal cancer (CRC). Methods: A two-arm parallel cluster randomised trial design will be used to compare two identical, structured implementation approaches, distinguished only by the use of theory to identify barriers and design targeted intervention strategies, to improve LS referral practices in eight large Australian hospital networks. Each hospital network will be randomly allocated to a trial arm, with stratification by state. A trained healthcare professional will lead the following phases at each site: (1) undertake baseline clinical practice audits, (2) form multidisciplinary Implementation Teams, (3) identify target behaviours for practice change, (4) identify barriers to change, (5) generate intervention strategies, (6) support staff to implement interventions and (7) evaluate the effectiveness of the intervention using post-implementation clinical data. The theoretical and non-theoretical components of each trial arm will be distinguished in phases 4-5. Study outcomes include a LS referral process map for each hospital network, with evaluation of the proportion of patients with risk-appropriate completion of the LS referral pathway within 2 months of CRC resection pre and post implementation. Discussion: This trial will determine the more effective approach for improving the detection of LS amongst patients with CRC, whilst also advancing understanding of the impact of theory-based implementation approaches in complex health systems and the feasibility of training healthcare professionals to use them. Insights gained will guide the development of future interventions to improve LS identification on a larger scale and across different contexts, as well as efforts to address the gap between evidence and practice in the rapidly evolving field of genomic research. Trial registration: ANZCTR, ACTRN12618001072202. Registered on 27 June 2018

Fossils from Mille-Logya, Afar, Ethiopia, elucidate the link between Pliocene environmental changes and Homo origins

Several hypotheses posit a link between the origin of Homo and climatic and environmental shifts between 3 and 2.5 Ma. Here we report on new results that shed light on the interplay between tectonics, basin migration and faunal change on the one hand and the fate of Australopithecus afarensis and the evolution of Homo on the other. Fieldwork at the new Mille-Logya site in the Afar, Ethiopia, dated to between 2.914 and 2.443 Ma, provides geological evidence for the northeast migration of the Hadar Basin, extending the record of this lacustrine basin to Mille-Logya. We have identified three new fossiliferous units, suggesting in situ faunal change within this interval. While the fauna in the older unit is comparable to that at Hadar and Dikika, the younger units contain species that indicate more open conditions along with remains of Homo. This suggests that Homo either emerged from Australopithecus during this interval or dispersed into the region as part of a fauna adapted to more open habitats.info:eu-repo/semantics/publishedVersio