Usefulness of movement time in the assessment of Parkinson’s disease

Abstract Reaction time (RT) and movement time (MT) are reported to be delayed in Parkinson's disease (PD), but their clinical utility and relationship with clinical findings is still uncertain. We investigated RT and MT in 22 PD patients at baseline conditions and following acute oral trials of levodopa and biperiden, an anticholinergic drug. At baseline conditions, RT and MT of PD patients were abnormally delayed compared with those of 16 normal control subjects. Both RT and MT were longer in more severely affected patients compared with the mild PD patients; in the mild PD patients with asymmetrical signs both responses were longer on the more affected side. Bradykinesia was the clinical symptom that best correlated with the objective measurements, with a stronger correlation for MT than for RT. The oral administration of levodopa significantly improved both the responses, whereas biperiden was ineffective. The magnitude of RT and MT improvement after levodopa differed; MT improvement was related to PD severity, whereas RT improvement was not. These results suggest that MT, rather than RT, is an objective, simple, and reliable tool to evaluate bradykinesia and its levodopa-induced modifications in PD

A Policy-Ready Public Health Guidebook of Strategies and Indicators to Promote Financial Well-Being and Address Financial Strain in Response to COVID-19

Introduction The COVID-19 pandemic has adversely affected the financial well-being of populations globally, escalating concerns about links with health care and overall well-being. Governments and organizations need to act quickly to protect population health relative to exacerbated financial strain. However, limited practice and policy-relevant resources are available to guide action, particularly from a public health perspective, that is, targeting equity, social determinants of health, and health-in-all policies. Our study aimed to create a public health guidebook of strategies and indicators for multisectoral action on financial well-being and financial strain by decision makers in high-income contexts. Methods We used a multimethod approach to create the guidebook. We conducted a targeted review of existing theoretical and conceptual work on financial well-being and strain. By using rapid review methodology informed by principles of realist review, we collected data from academic and practice-based sources evaluating financial well-being or financial strain initiatives. We performed a critical review of these sources. We engaged our research–practice team and government and nongovernment partners and participants in Canada and Australia for guidance to strengthen the tool for policy and practice. Results The guidebook presents 62 targets, 140 evidence-informed strategies, and a sample of process and outcome indicators. Conclusion The guidebook supports action on the root causes of poor financial well-being and financial strain. It addresses a gap in the academic literature around relevant public health strategies to promote financial well-being and reduce financial strain. Community organizations, nonprofit organizations, and governments in highincome countries can use the guidebook to direct initiative design, implementation, and assessmen

Lessons from Two Years of Building Fusion Ignition Targets with the Precision Robotic Assembly Machine

The Precision Robotic Assembly Machine was developed to manufacture the small and intricate laser-driven fusion ignition targets that are being used in the world's largest and most energetic laser, the National Ignition Facility (NIF). The National Ignition Campaign (NIC) goal of using the NIF to produce a self-sustaining nuclear fusion burn with energy gain - for the first time ever in a laboratory setting - requires targets that are demanding in materials fabrication, machining, and assembly. We provide an overview of the design and function of the machine, with emphasis on the aspects that revolutionized how NIC targets are manufactured

Lawson criterion for ignition exceeded in an inertial fusion experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion

Designing a framework for primary health care research in Canada: a scoping literature review

Abstract Background Despite significant investments to improve primary health care (PHC) delivery in Canada, provincial health care systems remain fragmented and uncoordinated. Canada’s commitment to strengthening PHC should be driven by robust research and evaluation that reflects our health policy priorities and responds to the needs of the population. One challenge facing health services researchers is developing and sustaining meaningful research priorities and agendas in an overburdened, complex health care system with limited capacity for PHC research and support for clinician researchers. Methods A scoping review of the literature was conducted to examine PHC research priorities in Canada. We compared national research priorities for PHC to research priorities being considered in the province of Alberta. Our scoping review was guided by the following questions: (1) What are the research priorities for PHC in Canada?; and (2) What process is used to identity PHC research priorities? Results Six key theme areas for consideration in setting a PHC research agenda were identified: research in practice, research on practice, research about practice, methods of priority setting, infrastructure, and the intersection of PHC and population/public health. These thematic areas provide a new framework for guiding PHC research in Canada. It was developed to generate best practices and new knowledge (i.e., innovation), transform PHC clinical practice or support quality improvement (i.e., spread), and lead to large-scale health care system transformation (i.e., scale). Conclusions Priority-driven research aims to answer questions of key importance that are likely to have a significant impact on knowledge or practice in the short to medium term. Setting PHC research priorities ensures funded research has the greatest potential population health benefit, that research funding and outputs are aligned with the needs of practitioners and decision makers, and that there is efficient and equitable use of limited resources with less duplication of research effort. Our findings also suggest that a common research priority framework for PHC research in Canada would ensure that research priority-setting exercises are grounded in an evidence-based process