Translation of evidence-based Assistive Technologies into stroke rehabilitation: Users' perceptions of the barriers and opportunities

Background: Assistive Technologies (ATs), defined as "electrical or mechanical devices designed to help people recover movement", demonstrate clinical benefits in upper limb stroke rehabilitation; however translation into clinical practice is poor. Uptake is dependent on a complex relationship between all stakeholders. Our aim was to understand patients', carers' (P&Cs) and healthcare professionals' (HCPs) experience and views of upper limb rehabilitation and ATs, to identify barriers and opportunities critical to the effective translation of ATs into clinical practice. This work was conducted in the UK, which has a state funded healthcare system, but the findings have relevance to all healthcare systems. Methods. Two structurally comparable questionnaires, one for P&Cs and one for HCPs, were designed, piloted and completed anonymously. Wide distribution of the questionnaires provided data from HCPs with experience of stroke rehabilitation and P&Cs who had experience of stroke. Questionnaires were designed based on themes identified from four focus groups held with HCPs and P&Cs and piloted with a sample of HCPs (N = 24) and P&Cs (N = 8). Eight of whom (four HCPs and four P&Cs) had been involved in the development. Results: 292 HCPs and 123 P&Cs questionnaires were analysed. 120 (41%) of HCP and 79 (64%) of P&C respondents had never used ATs. Most views were common to both groups, citing lack of information and access to ATs as the main reasons for not using them. Both HCPs (N = 53 [34%]) and P&C (N = 21 [47%]) cited Functional Electrical Stimulation (FES) as the most frequently used AT. Research evidence was rated by HCPs as the most important factor in the design of an ideal technology, yet ATs they used or prescribed were not supported by research evidence. P&Cs rated ease of set-up and comfort more highly. Conclusion: Key barriers to translation of ATs into clinical practice are lack of knowledge, education, awareness and access. Perceptions about arm rehabilitation post-stroke are similar between HCPs and P&Cs. Based on our findings, improvements in AT design, pragmatic clinical evaluation, better knowledge and awareness and improvement in provision of services will contribute to better and cost-effective upper limb stroke rehabilitation. © 2014 Hughes et al.; licensee BioMed Central Ltd

One moment, please: can the speed and quality of political contact affect democratic health

Contact between politicians and their constituents is the cornerstone of democracies globally but an area of scholarship that remains relatively underdeveloped. Political contact can help convey authority, provide legitimacy and facilitate governance. This article goes beyond the assumption that representatives need to communicate more with the public and suggests, instead, that the quality of contact matters. Focusing on four processes by which citizens can contact their representatives (face-to-face, by letter, email or social media), we employ an experimental vignette methodology to test whether the character and timeliness of politicians’ responses to citizen communication affects two indicators of democratic health: (a) the latter’s satisfaction with political contact and (b) their likelihood to re-contact representatives. Our findings provide evidence that personalised communication and to a smaller extent, speed of response, can influence citizen satisfaction and their likelihood of re-engagement. This suggests politicians can improve these indicators of democratic health by adjusting the style of political contact and communication

Cognitive-enhancing effects of angiotensin IV

Angiotensin IV is a derivative of the potent vasoconstrictor angiotensin II and it has been shown to enhance acquisition, consolidation and recall in animal models of learning and memory when administered centrally or peripherally. Whether changes in angiotensin IV activity underlie the cognitive effects of those cardiovascular drugs designed to disrupt the peripheral renin-angiotensin system in humans remains undetermined, but angiotensin IV appears to be a worthy candidate for consideration in drug development programmes. The mechanism of action of angiotensin IV is still debated, although its AT4 receptor has been convincingly identified as being insulin-regulated amino peptidase, which is also known as oxytocinase and placental leucine aminopeptidase. It is speculated that angiotensin IV may interact with insulin-regulated amino peptidase to enhance neuronal glucose uptake, prevent metabolism of other neuroactive peptides, induce changes in extracellular matrix molecules, or induce release of acetylcholine and/or dopamine. All of these things may be responsible for the beneficial effects on cognition, but none of them are yet proven. Importantly, strain differences in murine responses to angiotensin IV suggest that some individuals may benefit from drugs targeted to the AT4 receptor whilst others may be refractory. At present it thus appears that those individuals with the poorest baseline cognition may receive greatest benefit, but possible genetic differences in responses to angiotensin IV cannot be ruled-out

3D meso-scale modelling of concrete material in spall tests

Tensile strength is one of the key factors of concrete material that need be accurately defined in analysis of concrete structures subjected to high-speed impact loads. Dynamic tensile strength of concrete material is usually obtained by conducting laboratory tests such as direct tensile test, Brazilian splitting test and spall test. Concrete is a heterogeneous material with different components, but is conventionally assumed to be homogeneous, i.e., cement mortar only, in most previous experimental or numerical studies. The aggregates in concrete material are usually neglected owing to testing limitation and numerical simplification. It has been well acknowledged that neglecting coarse aggregates might not necessarily give accurate concrete dynamic material properties. In the present study, a 3D meso-scale model of concrete specimen with consideration of cement mortar and aggregates is developed to simulate spall tests and investigate the behaviour of concrete material under high strain rate. The commercial software LS-DYNA is used to perform the numerical simulations of spall tests. The mesh size sensitivity is examined by conducting mesh convergence tests. The reliability of the numerical model in simulating the spall tests is verified by comparing the numerical results with the experimental data from the literature. The influence of coarse aggregates on the experimental test results is studied. The wave attenuation in concrete specimen is analysed, and empirical equations are proposed for quick assessment of the test data to determine the true dynamic tensile strength of concrete material. The contributions of aggregates to dynamic strength in spall tests are quantified for modifying the test results based on mortar material in the literature

Valorisation to biogas of macroalgal waste streams: a circular approach to bioproducts and bioenergy in Ireland

© 2016 The Author(s) Seaweeds (macroalgae) have been recently attracting more and more interest as a third generation feedstock for bioenergy and biofuels. However, several barriers impede the deployment of competitive seaweed-based energy. The high cost associated to seaweed farming and harvesting, as well as their seasonal availability and biochemical composition currently make macroalgae exploitation too expensive for energy production only. Recent studies have indicated a possible solution to aforementioned challenges may lay in seaweed integrated biorefinery, in which a bioenergy and/or biofuel production step ends an extractions cascade of high-value bioproducts. This results in the double benefit of producing renewable energy while adopting a zero waste approach, as fostered by recent EU societal challenges within the context of the Circular Economy development. This study investigates the biogas potential of residues from six indigenous Irish seaweed species while discussing related issues experienced during fermentation. It was found that Laminaria and Fucus spp. are the most promising seaweed species for biogas production following biorefinery extractions producing 187–195 mL CH4 gVS−1 and about 100 mL CH4 gVS−1 , respectively, exhibiting overall actual yields close to raw un-extracted seaweed

Clinical trials for stem cell therapies

In recent years, clinical trials with stem cells have taken the emerging field in many new directions. While numerous teams continue to refine and expand the role of bone marrow and cord blood stem cells for their vanguard uses in blood and immune disorders, many others are looking to expand the uses of the various types of stem cells found in bone marrow and cord blood, in particular mesenchymal stem cells, to uses beyond those that could be corrected by replacing cells in their own lineage. Early results from these trials have produced mixed results often showing minor or transitory improvements that may be attributed to extracellular factors. More research teams are accelerating the use of other types of adult stem cells, in particular neural stem cells for diseases where beneficial outcome could result from either in-lineage cell replacement or extracellular factors. At the same time, the first three trials using cells derived from pluripotent cells have begun