Factors influencing community case management and care hours for clients with traumatic brain injury living in the UK

Objective: To investigate the relationship between deficits associated with traumatic brain injury (TBI) and case management (CM) and care/support (CS) in two UK community samples. Research design: Prospective descriptive study. Method: Case managers across the UK and from a single UK CM service contributed client profiles to two data sets (Groups 1 and 2, respectively). Data were entered on demographics, injury severity, functional skills, functional-cognition (including executive functions), behaviour and CM and CS hours. Relationships were explored between areas of disability and service provision. Results: Clients in Group 2 were more severely injured, longer post-injury and had less family support than clients in Group 1. There were few significant differences between Groups 1 and 2 on measures of Functionalskill, Functional-cognition and Behaviour disorder. Deficits in Functionalskills were associated with CS, but not CM. Deficits in measures of executive functions (impulsivity, predictability, response to direction) were related to CM, but not to CS. Insight was related to both CM and CS. Variables related to behaviour disorder were related to CM, but were less often correlated to CS. Conclusions: The need for community support is related not only to Functionalskills (CS), but also to behaviour disorder, self-regulatory skills and impaired insight (CM)

Experiences of challenges and support among family members of people with acquired brain injury: a qualitative study in the UK

Primary objective: Family members (FM) are affected by the impact of an Acquired Brain Injury (ABI) upon their relatives and play an important role in rehabilitation and long-term support. This study explores how families are affected and integrates their views on the formal/informal support received as a consequence of ABI. Research design: A qualitative research design was employed to capture the lived experience of FM of people with ABI. Method: Semi-structured interviews were conducted with 16 FM of people with severe ABI. Participants were chosen from respondents to a UK national online survey of affected individuals. Interview data were analysed using inductive thematic analysis. Results: Family members’ experiences are complex, enduring and are affected by the context in which the ABI occurs as well as by formal/informal support. The grief experienced by FM is ambiguous, develops over time and FM perceive little option but to remain involved. Experience of formal and informal support is noted to vary significantly in availability and quality, poor support exacerbates difficulties and isolates family members. Conclusion: Greater understanding of the lived experience of FM is needed to support more effective responses to both them and the individual with ABI, integrating services and families to improve quality-of-life

An analysis on the convergence of equal-time commutators and the closure of the BRST algebra in Yang-Mills theories

In renormalizable theories, we define equal-time commutators (ETC'S) in terms of the equal-time limit and investigate its convergence in perturbation theory. We find that the equal-time limit vanishes for amplitudes with the effective dimension d_{\em eff} \leq -2 and is finite for those with d_{\em eff} =-1 but without nontrivial discontinuity. Otherwise we expect divergent equal-time limits. We also find that, if the ETC's involved in verifying an Jacobi identity exist, the identity is satisfied. Under these circumstances, we show in the Yang-Mills theory that the ETC of the $0$ component of the BRST current with each other vanishes to all orders in perturbation theory if the theory is free from the chiral anomaly, from which we conclude that $[\, Q\,,\,Q\,]=0$, where $Q$ is the BRST charge. For the case that the chiral anomaly is not canceled, we use various broken Ward identities to show that $[\, Q\,,\,Q\,]$ is finite and $[\,Q\,,\,[\, Q\,,\,Q]\,]$ vanishes at the one-loop level and that they start to diverge at the two-loop level unless there is some unexpected cancellation mechanism that improves the degree of convergence.Comment: 35 page

Expressions 1997

https://openspace.dmacc.edu/expressions/1017/thumbnail.jp

The Primary PE and School Sport Premium

Central to London’s successful bid to host the 2012 Olympic and Paralympic Games, was the Government’s commitment to improve competitive sport and the sporting habits of young people (Ofsted, 2014). On the 12th March 2013, the then Prime Minister, David Cameron, announced that Primary Schools in England would receive funding worth £150 million per year to create a sustainable infrastructure for long-lasting change and improve the provision of physical education (PE) and sport across all state maintained primary schools. Speaking at the time, he said: ‘We can create a culture in our schools that encourages all children to be active and enjoy sport.’ He added: ‘The Olympic and Paralympic Games marked an incredible year for this country and I will always be proud that we showed the world what Britain can do. I want to ensure the Games count for the future too and that means capitalising on the inspiration young people took from what they saw during those summer months.’: https://www.bbc.co.uk/sport/21808982 Six years on, and with a total investment now of over £1.2 billion, the Primary PE and Sport Premium (here onwards referred to as the PESS Premium) has been a defining feature of the London 2012 legacy. Invariably funding streams at this level do not last forever or in the same format, which raises significant questions about what impact the funding has had on young people since 2013. We believe that a significant investment from Government merits debate and accountability at the highest possible level and that it should acknowledge where the opportunities and shortcomings of such a policy have left us. During the years of austerity, mounting concerns have arisen over the present and long term state of children’s health and the need for the debate to be heard is now imperative. To date there has been little critical appraisal of the PESS Premium funding. This report aims to begin a necessary process and in doing so, brings together evidence from across the sector to consider the future of the PESS Premium post 2018. During the course of the report, we outline and underpin the holistic value and importance of PE for every child. We examine the historic status and funding of PE and Sport and the nature and increasing diversity of the workforce. How has the PESS Premium funding impacted the way in which the subject is regarded and the ability of those tasked with delivering it to discharge their responsibilities? We have uncovered an abiding uncertainty about the nature of the PESS Premium itself; the ways in which it may be spent and its effect on an increasing divide between PE specialists, generalists and externally contracted coaches. Will its legacy be to have established a secure foundation for lifelong physical activity, sport and education – or is it, in effect, another temporarily seductive mirage, leaving PE precisely where it has become accustomed to be; regularly sidelined, delivered largely by those who are not qualified teachers and perpetuating the status quo for the children who already belong to groups that are perceived to be at a disadvantage? The PESS Premium funding is a significant sum and these questions deserve answers. This report is therefore our contribution to an essential debate, containing practical suggestions that we hope will be of use to policy makers. We invite all who care about the physical and mental health and emotional wellbeing of children to join the discussion

Green Mind Theory: How Brain-Body-Behaviour Links into Natural and Social Environments for Healthy Habits

We propose a Green Mind Theory (GMT) to link the human mind with the brain and body, and connect the body into natural and social environments. The processes are reciprocal: environments shape bodies, brains, and minds; minds change body behaviours that shape the external environment. GMT offers routes to improved individual well-being whilst building towards greener economies. It builds upon research on green exercise and nature-based therapies, and draws on understanding derived from neuroscience and brain plasticity, spiritual and wisdom traditions, the lifeways of original cultures, and material consumption behaviours. We set out a simple metaphor for brain function: a bottom brain stem that is fast-acting, involuntary, impulsive, and the driver of fight and flight behaviours; a top brain cortex that is slower, voluntary, the centre for learning, and the driver of rest and digest. The bottom brain reacts before thought and directs the sympathetic nervous system. The top brain is calming, directing the parasympathetic nervous system. Here, we call the top brain blue and the bottom brain red; too much red brain is bad for health. In modern high-consumption economies, life has often come to be lived on red alert. An over-active red mode impacts the gastrointestinal, immune, cardiovascular, and endocrine systems. We develop our knowledge of nature-based interventions, and suggest a framework for the blue brain-red brain-green mind. We show how activities involving immersive-attention quieten internal chatter, how habits affect behaviours across the lifecourse, how long habits take to be formed and hard-wired into daily practice, the role of place making, and finally how green minds could foster prosocial and greener economies. We conclude with observations on twelve research priorities and health interventions, and ten calls to action

Maximum Likelihood Estimation of the Negative Binomial Dispersion Parameter for Highly Overdispersed Data, with Applications to Infectious Diseases

BACKGROUND: The negative binomial distribution is used commonly throughout biology as a model for overdispersed count data, with attention focused on the negative binomial dispersion parameter, k. A substantial literature exists on the estimation of k, but most attention has focused on datasets that are not highly overdispersed (i.e., those with k≥1), and the accuracy of confidence intervals estimated for k is typically not explored. METHODOLOGY: This article presents a simulation study exploring the bias, precision, and confidence interval coverage of maximum-likelihood estimates of k from highly overdispersed distributions. In addition to exploring small-sample bias on negative binomial estimates, the study addresses estimation from datasets influenced by two types of event under-counting, and from disease transmission data subject to selection bias for successful outbreaks. CONCLUSIONS: Results show that maximum likelihood estimates of k can be biased upward by small sample size or under-reporting of zero-class events, but are not biased downward by any of the factors considered. Confidence intervals estimated from the asymptotic sampling variance tend to exhibit coverage below the nominal level, with overestimates of k comprising the great majority of coverage errors. Estimation from outbreak datasets does not increase the bias of k estimates, but can add significant upward bias to estimates of the mean. Because k varies inversely with the degree of overdispersion, these findings show that overestimation of the degree of overdispersion is very rare for these datasets

Chapter Ten - Informing marine spatial planning decisions with environmental DNA

Marine management areas provide a key tool for efforts towards sustainable development, reconciling socio-economic goals with those for biodiversity conservation. Decisions about where and when to establish spatial management areas in the oceans are currently hampered by the uncertainties of incomplete, or overly general, information about biodiversity. The analysis of environmental DNA (eDNA) provides a potentially powerful tool to overcome this lack of data in the future. Here we present directions to develop robust approaches to integrate eDNA and spatial planning processes, aiming to provide guidance to underpin tool development. The potential of eDNA use in conservation is widely recognised, although direct applications almost exclusively focus on detection of invasive or threatened species and not spatial management decisions. The implementation of broader interaction between the fields of conservation science and eDNA analysis could create substantial benefits to biodiversity conservation and management. In particular, eDNA analysis can provide information on biodiversity over spatial-temporal scales that are currently prohibitive in spatial planning studies. Here, we provide an overview of how eDNA is currently used in conservation practice, in addition to understanding its limitations and benefits within the context of spatial planning. With the goal to harness rapid technological developments in both molecular and conservation sciences, we provide a horizon scan of the future of eDNA analysis and its application to inform biodiversity conservation in a rapidly changing world

Adherence with isoniazid for prevention of tuberculosis among HIV-infected adults in South Africa

BACKGROUND: Tuberculosis (TB) is the most common opportunistic infection in HIV-infected adults in developing countries. Isoniazid (INH) is recommended for treatment of latent TB infection, however non-adherence is common. The purpose of this study was to apply in-house prepared isoniazid (INH) urine test strips in a clinical setting, and identify predictors of positive test results in an adherence questionnaire in HIV-infected adults taking INH for prevention of TB. METHODS: Cross-sectional study of adherence using a questionnaire and urine test strips for detection of INH metabolites at two hospitals in Pietermaritzburg, South Africa. Participants were aged at least 18 years, HIV positive, and receiving INH for prevention of tuberculosis disease. Univariate and multivariate analyses are used to identify factors relevant to adherence. RESULTS: 301 consecutive patients were recruited. 28% of participants had negative urine tests. 32 (37.2%, 95% CI25.4, 45.0) of the 86 patients who received INH from peripheral pharmacies said the pharmacy had run out of INH at some time, compared with central hospital pharmacies (p = 0.0001). In univariate analysis, a negative test was associated with self-reported missed INH doses (p = 0.043). Each 12-hour increment since last reported dose increased the likelihood of a negative test by 34% (p = 0.0007). Belief in INH safety was associated with a positive test (p = 0.021). In multivariate analysis, patients who believed INH is important for prevention of TB disease were more likely to be negative (p = 0.0086). CONCLUSION: Adequate drug availability at peripheral pharmacies remains an important intervention for TB prevention. Key questions may identify potentially non-adherent patients. In-house prepared urine tests strips are an effective and cheap method of objectively assessing INH adherence, and could be used an important tool in TB control programs

Precise measurement of the W-boson mass with the CDF II detector

We have measured the W-boson mass MW using data corresponding to 2.2/fb of integrated luminosity collected in proton-antiproton collisions at 1.96 TeV with the CDF II detector at the Fermilab Tevatron collider. Samples consisting of 470126 W->enu candidates and 624708 W->munu candidates yield the measurement MW = 80387 +- 12 (stat) +- 15 (syst) = 80387 +- 19 MeV. This is the most precise measurement of the W-boson mass to date and significantly exceeds the precision of all previous measurements combined