Broken Puppet Symposia

Broken Puppet Symposia introduces the reader to the contents of this double special issue on applied puppetry and health. It starts with the Editors’ definition of a Puppet to move on to important theoretical articles, revealing notes from the field (projects and practitioners), fascinating interviews with experts in performance in healthcare and beautiful illustrations. The Editors bring their experience of organising the Broken Puppet Symposia in Cork, Bath and Birmingham and the learning they gained from working with puppeteers, therapists and academics

Does a monetary incentive improve the response to a postal questionnaire in a randomised controlled trial? : the MINT incentive study

Background: Sending a monetary incentive with postal questionnaires has been found to improve the proportion of responders, in research in non-healthcare settings. However, there is little research on use of incentives to improve follow-up rates in clinical trials, and existing studies are inconclusive. We conducted a randomised trial among participants in the Managing Injuries of the Neck Trial (MINT) to investigate the effects on the proportion of questionnaires returned and overall non-response of sending a £5 gift voucher with a follow-up questionnaire. Methods: Participants in MINT were randomised to receive either: (a) a £5 gift voucher (incentive group) or (b) no gift voucher (no incentive group), with their 4 month or 8 month follow-up questionnaire. We recorded, for each group, the number of questionnaires returned, the number returned without any chasing from the study office, the overall number of non-responders (after all chasing efforts by the study office), and the costs of following up each group. Results: 2144 participants were randomised, 1070 to the incentive group and 1074 to the no incentive group. The proportion of questionnaires returned (RR 1.10 (95% CI 1.05, 1.16)) and the proportion returned without chasing (RR 1.14 (95% CI 1.05, 1.24) were higher in the incentive group, and the overall non-response rate was lower (RR 0.68 (95% CI 0.53, 0.87)). Adjustment for injury severity and hospital of recruitment to MINT made no difference to these results, and there were no differences in results between the 4-month and 8-month follow up questionnaires. Analysis of costs suggested a cost of £67.29 per additional questionnaire returned. Conclusion: Monetary incentives may be an effective way to increase the proportion of postal questionnaires returned and minimise loss to follow-up in clinical trials

A national survey of clinical practice for the management of whiplash-associated disorders in UK emergency departments

Objective: To undertake a national survey to determine current practice for the management of whiplash injuries in UK emergency departments (ED). Methods: Postal questionnaire survey. 316 lead consultants from all UK ED with annual new attendances of over 50 000 people were asked to indicate the use of a range of treatments and the frequency with which these treatments were used. Samples of written advice were requested and content analysis was conducted and compared with survey responses. Results: The response rate was 79% (251/316). The intervention most frequently used was verbal advice to exercise, reported by 84% of respondents for most or all cases, and advice against the use of a collar (83%). Other treatments reported as being used frequently were written advice and anti-inflammatory medication. 106 consultants (42%) provided a sample of written materials. Reference to expected recovery and encouragement for early return to activities were included in less than 6%. Nearly 50% of written materials contained information on how to use a soft collar and 61% contained information on solicitors and pursuing a personal injury claim. There were important differences between reported verbal behaviours and written advice. Conclusion: Verbal advice is the primary method for managing whiplash injuries in ED and is usually supplemented by written advice. Within individual hospitals there is a lack of consistency between verbal and written advice. The promotion of personal injury claims is a common feature of written advice. Research is required to develop effective and consistent models of advice

Short-Term Thermal Acclimation Modifies the Metabolic Condition of the Coral Holobiont

The nutritional symbiosis between coral hosts and photosynthetic dinoflagellates is fundamental to the functioning of coral reefs. Rising seawater temperatures destabilize this relationship, resulting in drastic declines in world-wide coral cover. Thermal history is thought to play an important role in shaping a coral\u27s response to subsequent thermal stress. Here, we exposed Pocillopora damicornis to two thermal acclimation regimes (ambient vs. warm) and compared the effect that acclimation had on the coral holobiont\u27s response to a subsequent seven day heat stress event. We conducted daily physiological measurements at the holobiont level (gross photosynthesis, respiration, host protein content, symbiont density and chlorophyll content) throughout the heating event, as well as cellular-level imaging of 13C-bicarbonate and 15N-nitrate assimilation (using NanoSIMS) at the end of the heat stress event. Thermal acclimation history had a negligible effect on the measurements conducted at the holobiont level during the heat stress event. No differences were observed in the O2-budget between ambient and warm-acclimated corals and only small fluctuations in host protein, symbiont density and chlorophyll content were detected. In contrast, this lack of differential response, was not mirrored at the cellular level. Warm-acclimated corals had substantially higher 13C enrichment in the host gastrodermis and lipid bodies, but significantly lower 15N-nitrate assimilation in the symbionts and the host tissue layers, relative to the ambient-acclimated corals. We discuss potential reasons for the disconnect that occurred between symbiont bicarbonate and nitrate assimilation (in the absence of photosynthetic breakdown) in the warm-acclimated corals. We suggest this represents either a shift in nitrogen utilization, or supply limitation by the host. Our findings raise several interesting hypotheses regarding the role that nitrogen metabolism plays in thermal stress, which will warrant further investigation if we are to understand the acclimatization capacity of the coral holobiont

Editorial

This is the editorial for the special issue of the Journal of Applied Arts and Health Issue 11.1 and 11.2 on puppetry and healt

Managing Injuries of the Neck Trial (MINT) : design of a randomised controlled trial of treatments for whiplash associated disorders

Background: A substantial proportion of patients with whiplash injuries develop chronic symptoms. However, the best treatment of acute injuries to prevent long-term problems is uncertain. A stepped care treatment pathway has been proposed, in which patients are given advice and education at their initial visit to the emergency department (ED), followed by review at three weeks and physiotherapy for those with persisting symptoms. MINT is a two-stage randomised controlled trial to evaluate two components of such a pathway: 1. use of The Whiplash Book versus usual advice when patients first attend the emergency department; 2. referral to physiotherapy versus reinforcement of advice for patients with continuing symptoms at three weeks. Methods: Evaluation of the Whiplash Book versus usual advice uses a cluster randomised design in emergency departments of eight NHS Trusts. Eligible patients are identified by clinicians in participating emergency departments and are sent a study questionnaire within a week of their ED attendance. Three thousand participants will be included. Patients with persisting symptoms three weeks after their ED attendance are eligible to join an individually randomised study of physiotherapy versus reinforcement of the advice given in ED. Six hundred participants will be randomised. Follow-up is at 4, 8 and 12 months after their ED attendance. Primary outcome is the Neck Disability Index (NDI), and secondary outcomes include quality of life and time to return to work and normal activities. An economic evaluation is being carried out. Conclusion: This paper describes the protocol and operational aspects of a complex intervention trial based in NHS emergency and physiotherapy departments, evaluating two components of a stepped-care approach to the treatment of whiplash injuries. The trial uses two randomisations, with the first stage being cluster randomised and the second individually randomised

Early-time Spectropolarimetry of the Asymmetric Type II Supernova SN 2023ixf

We present six epochs of optical spectropolarimetry of the Type II supernova (SN) 2023ixf ranging from $\sim$ 2 to 15 days after the explosion. Polarimetry was obtained with the Kast double spectrograph on the Shane 3 m telescope at Lick Observatory, representing the earliest such observations ever captured for an SN. We observe a high continuum polarization $p_{\text{cont}} \approx 1$ % on days +1.4 and +2.5 before dropping to 0.5 % on day +3.5, persisting at that level up to day +14.5. Remarkably, this change coincides temporally with the disappearance of highly ionized "flash" features. The decrease of the continuum polarization is accompanied by a $\sim 70^\circ$ rotation of the polarization position angle ($PA$) as seen across the continuum. The early evolution of the polarization may indicate different geometric configurations of the electron-scattering atmosphere as seen before and after the disappearance of the emission lines associated with highly-ionized species (e.g., He II, C IV, N III), which are likely produced by elevated mass loss shortly prior to the SN explosion. We interpret the rapid change of polarization and $PA$ from days +2.5 to +4.5 as the time when the SN ejecta emerge from the dense asymmetric circumstellar material (CSM). The temporal evolution of the continuum polarization and the $PA$ is consistent with an aspherical SN explosion that exhibits a distinct geometry compared to the CSM. The rapid follow-up spectropolarimetry of SN 2023ixf during the shock ionization phase reveals an exceptionally asymmetric mass-loss process leading up to the explosion.Comment: Submitted to Ap

Defining the target population to make marine image-based biological data FAIR

Marine imaging studies have unique constraints on the data collected requiring a tool for defining the biological scope to facilitate data discovery, quality evaluation, sharing and reuse. Defining the ‘target population’ is way of scoping biological sampling or observations by setting the pool of organisms to be observed or sampled. It is used in survey design and planning, to determine statistical inference, and is critical for data interpretation and reuse (both images and derived data). We designed a set of attributes for defining and recording the target population in biological studies using marine photography, incorporating ecological and environmental delineation and marine imaging method constraints. We describe how this definition may be altered and recorded at different phases of a project. The set of attributes records the definition of the target population in a structured metadata format to enhance data FAIRness. It is designed as an extension to the image FAIR Digital Objects metadata standard, and we map terms to other biological data standards where possible. This set of attributes serves a need to update ecological metadata to align with new remotely-sensed data, and can be applied to other remotely-sensed ecological image data

Ultraselective, Ultrahigh Resolution 1D TOCSY

Solution state 1H NMR spectroscopy provides valuable insights into molecular structure and conformation. However, when the spectrum exhibits severe signal overlap, it hampers the extraction of key structural information. Here, an ultraselective, ultrahigh resolution TOCSY method is introduced that greatly reduces spectral complexity, allowing the extraction of previously inaccessible spectral information. It combines the recently developed GEMSTONE excitation with homonuclear decoupling to provide highly simplified through-bond correlation 1D 1H NMR spectra, showing all signals within the selected spin system as singlets. The new method can greatly facilitate the analysis of mixtures, as shown here for a mixture of Cinchona alkaloids (popular catalysts in asymmetric synthesis) and a mixture of glucocorticoids (used for treating conditions such as asthma)

The Joint IOC (of UNESCO) and WMO collaborative effort for met-ocean services

The Joint Committee for Oceanography and Marine Meteorology (JCOMM), a joint technical commission of IOC of UNESCO and WMO, has devised a coordination mechanism for the fit-for-purpose delivery of an end-to-end system, from ocean observations to met-ocean operational services. This paper offers a complete overview of the activities carried out by JCOMM and the status of the achievements up to 2017. The JCOMM stakeholders are the WMO Members and the IOC Member States, their research and operational Institutions, which mandated JCOMM to devise an international strategy to advance toward the achievement of the United Nations Sustainable Development Goals. The three activity areas, namely the Observation Program Area-OPA, the Data Management Program Area-DMPA and the Services and Forecasting Services Program Area-SFSPA have established several expert teams to contribute to the international coordination. OPA is organized in observing networks connected with different observing technologies, DMPA organizes the overall near-real time and delayed mode data assembly and delivery methodology and architecture and the SFSPA coordinates the met-ocean services stemming out of observations and data management. The future developments should strengthen the coordination in the three program areas considering the inclusion of new and emergent observing technologies, the interoperability of met-ocean data assembly centers and the establishment of efficient research to operations protocols, as well as better fit-for-purpose customized services for the public and private sectors