Changes In Events and Changes In Things

This is the text of The Lindley Lecture for 1962, given by Arthur N. Prior (1914-1969)

Rheumatology occupational therapy-led fibromyalgia self- management education using motivational interviewing and mindfulness based cognitive therapy : a new approach

Fibromyalgia is a chronic musculoskeletal pain syndrome, which significantly affects patients’ quality of life. EULAR revised recommendations for the management of Fibromyalgia suggests non-pharmacological therapies and patient education should be treatment priority. This puts Rheumatology Occupational Therapists in an important role on the patients’ journey to self-management. This article reports on a new treatment approach in Rheumatology Occupational Therapy-led Fibromyalgia Self-Management Education (FSME), which incorporates Motivational Interviewing, and Mindfulness Based Cognitive Therapy approaches within the Canadian Practice Process Framework. The Fibromyalgia self-management education programme was devised and delivered by an Advanced Clinical Specialist Occupational Therapist using a comprehensive literature review of the evidence base. The evaluation of the self-management education programme included the Revised Fibromyalgia Impact Questionnaire as a condition specific outcome measure, the 5 Facet Mindfulness Questionnaire-Short Form to measure the effectiveness of the Mindfulness training on patient’s thought patterns, and the Canadian Occupational Performance Measure to evaluate the impact of the occupational therapy intervention on treatment goals. Preliminary results of the clinical practice evaluation suggests that Rheumatology Occupational Therapy-led FSME is highly effective in achieving health behaviour change, shift in patients’ awareness and reducing relapse in the long-term

FINITE H-DIMENSION DOES NOT IMPLY EXPRESSIVE COMPLETENESS

Accepted versio

Combining Biophysical and Price Simulations to Assess the Economics of Long-Term Crop Rotations

Biophysical simulation models (e.g. APSIM) using historical rainfall data are increasingly being used to provide yield and other data on crop rotations in various regions of Australia. However, to analyse the economics of these rotations it is desirable to incorporate the other main driver of profitability, price variation. Because the context was that APSIM was being used to simulate an existing trial site being monitored by a farmer group Gross Margin output was considered most appropriate. Long-run rotational gross margins were calculated for the various rotations with yields (and other physical outputs) derived from APSIM simulations over a period of 100+ years and prices simulated in @Risk based on subjective triangular price distributions elicited from farmers in the group. Rotations included chickpeas, cotton, lucerne, sorghum, wheat and different lengths of fallow. Output presented to the farmers included mean annual gross margins and distributions of gross margins presented as probability distributions, cumulative probability distributions and box and whisker plots. Cotton rotations were the most profitable but had greater declines in soil fertility and greater drainage out of the root zone.Crop Production/Industries,

Combining biophysical and price simulations to assess the economics of long-term crop rotations

Long-run rotational gross margins were calculated with yields derived from biophysical simulations in APSIM over a period of 100+ years and prices simulated in @Risk based on subjective triangular price distributions elicited from the Jimbour Plains farmer group. Rotations included chickpeas, cotton, lucerne, sorghum, wheat and different lengths of fallow. Output presented to the farmers included mean annual GMs and distributions of GMs with box and whisker plots found to be suitable. Mean-standard deviation and first and second-degree stochastic dominance efficiency measures were also calculated. Including lucerne in the rotations improved some sustainability indicators but reduced profitability.Crop Production/Industries, Farm Management,

Diamonds are Forever

We defend the thesis that every necessarily true proposition is always true. Since not every proposition that is always true is necessarily true, our thesis is at odds with theories of modality and time, such as those of Kit Fine and David Kaplan, which posit a fundamental symmetry between modal and tense operators. According to such theories, just as it is a contingent matter what is true at a given time, it is likewise a temporary matter what is true at a given possible world; so a proposition that is now true at all worlds, and thus necessarily true, may yet at some past or future time be false in the actual world, and thus not always true. We reconstruct and criticize several lines of argument in favor of this picture, and then argue against the picture on the grounds that it is inconsistent with certain sorts of contingency in the structure of time

Synthesis and antibacterial effects of cobalt–cellulose magnetic nanocomposites

© The Royal Society of Chemistry. Green synthesis is employed to prepare cobalt/cellulose nanocomposites with cubic (α-cobalt) cobalt as a main component with antibacterial and magnetic properties. An in situ reduction of aqueous solutions of cobalt ions on a model cellulose substrate surface using hydrogen gas affords spherical, cellulose-stabilised cobalt nanoclusters with magnetic properties and an average diameter of 7 nm that are distributed evenly over the surface of the cellulose fibres. These cobalt/cellulose nanocomposites exhibit good antibacterial action against opportunistic pathogens both Gram-positive (S. aureus) and Gram-negative (E. coli, A. baumannii and P. aeruginosa), with zones of inhibition up to 15 mm, thereby encouraging the deployment of these advanced materials for the treatment of wastewater or within medical dressings. This method of preparation is compared with the analogous in situ reduction of cobalt ions on a cellulose surface using sodium borohydride as reducing agent

Inflammatory or rheumatoid arthritis patients’ perspectives on the effect of arthritis gloves on their hand pain and function (A-GLOVES TRIAL) : a qualitative study

Background: Arthritis (compression) gloves are frequently provided to people with inflammatory (IA) or rheumatoid arthritis (RA) in the NHS, to help reduce swelling and alleviate hand pain by providing compression and improving circulation. However evidence for their effectiveness is limited.[1] Objectives: Nested within a randomised controlled trial (RCT) testing the effectiveness of intervention (compression) gloves with control gloves (fitted at least one size too big) in people with RA and IA, this qualitative study aimed to explore patients’ perspectives on the effect of the arthritis gloves on their hand pain and function. Methods: Once randomised, participants were provided joint protection and hand exercise booklets and fitted with either the intervention or the control glove(s) by a trained occupational therapist.[2] Both gloves had similar thermal qualities but control gloves did not apply compression. Semi-structured interviews were conducted with 10 participants, purposively selected from each group (n=20) following 12 weeks of glove wear. Interviews were audio-recorded, transcribed and analysed by three researchers using thematic analysis with a critical realist perspective. Results: Participants’ perspectives on the effects of the arthritis gloves had three emergent sub-themes. These were: Usage: both groups predominantly used the gloves for activities such as wearing them outdoors to keep hands warm, night-time wear to help with sleep, and doing light domestic activities (e.g. dusting). Gloves were not used for cooking or washing-up or for personal activities of daily living (e.g. toileting, grooming) “What didn’t help as such, obviously was with washing etc. and toileting because I had to keep taking them off and putting them back on again”; Symptomatology: while some reported that gloves helped to keep their “hand pain in check” others said that gloves had no effect on their hand pain or that they’d found “it’s made them worse”. Participants from both groups frequently mentioned the warmth element of the gloves, as a positive attribute to help with their symptoms; Aesthetics: participants had opposing views on the appearance of the arthritis gloves. Some felt that the intervention gloves “look a bit ugly with the seams outside” or stated that they “would not want to wear that colour” but did not think they were obtrusive. Most noticeably, patients seemed to view the arthritis gloves as ordinary everyday gloves, rather than a medical device “if it was cold I wore them outside”. Conclusions: Trial participants reported experiencing similar effects from wearing either the intervention or control gloves, with varied perspectives on whether or not gloves affected hand pain and/or function. Overall, patients did not reflect on the compressive but rather the thermal qualities of the gloves, as warmth was the main effect perceived. References: Hammond, et al. Clin Rehabil 2016 30:213–24 Prior, et al. Rheum 2017(Supp1) Acknowledgements: This project was funded by the NIHR Research for Patient Benefit Programme (PB-PG-0214–33010). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health