The YOU CALL-WE CALL randomized clinical trial: Impact of a multimodal support intervention after a mild stroke

Background Comparison of a multimodal intervention WE CALL (study initiated phone support/information provision) versus a passive intervention YOU CALL (participant can contact a resource person) in individuals with first mild stroke. Methods and Results This study is a single-blinded randomized clinical trial. Primary outcome includes unplanned use of health services (participant diaries) for adverse events and quality of life (Euroquol-5D, Quality of Life Index). Secondary outcomes include planned use of health services (diaries), mood (Beck Depression Inventory II), and participation (Assessment of Life Habits [LIFE-H]). Blind assessments were done at baseline, 6, and 12 months. A mixed model approach for statistical analysis on an intention-to-treat basis was used where the group factor was intervention type and occasion factor time, with a significance level of 0.01. We enrolled 186 patients (WE=92; YOU=94) with a mean age of 62.5±12.5 years, and 42.5% were women. No significant differences were seen between groups at 6 months for any outcomes with both groups improving from baseline on all measures (effect sizes ranged from 0.25 to 0.7). The only significant change for both groups from 6 months to 1 year (n=139) was in the social domains of the LIFE-H (increment in score, 0.4/9±1.3 [95% confidence interval, 0.1–0.7]; effect size, 0.3). Qualitatively, the WE CALL intervention was perceived as reassuring, increased insight, and problem solving while decreasing anxiety. Only 6 of 94 (6.4%) YOU CALL participants availed themselves of the intervention. Conclusions Although the 2 groups improved equally over time, WE CALL intervention was perceived as helpful, whereas YOU CALL intervention was not used.

Study protocol of the YOU CALL - WE CALL TRIAL: Impact of a multimodal support intervention after a "mild" stroke

Background More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization. The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support) - "WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to) - "YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life. Method/Design We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar) and quality of life (EQ-5D and Quality of Life Index). Secondary outcomes include participation level (LIFE-H), depression (Beck Depression Inventory II) and use of health services for health promotion or prevention (frequency calendar). Blind assessors will gather data at mid-intervention, end of intervention and one year follow up. Discussion If effective, this multimodal intervention could be delivered in both urban and rural environments. For example, existing infrastructure such as regional stroke centers and existing secondary stroke prevention clinics, make this intervention, if effective, deliverable and sustainable.

‘We are here to make history’: The United Nations climate summit 2014

In the wake of the 400,000 strong Climate March in New York and the Flood Wall Street protest, the United Nations hosted a Climate Summit in New York on the 23 September 2014. The event was intended to be a catalyst for the development of a binding, fair, and ambitious international agreement upon climate change.

Gossip we can trust: Defamation law and non-fiction

Drawing on two case studies, this article considers the allegation of a disgruntled author: ’Defamation was framed to protect the reputations of 19th century gentlemen hypocrites'. The first case study considers the litigation over Bob Ellis' unreliable political memoir, ’Goodbye Jerusalem', published by Random House. The second case study focuses upon the litigation over the allegation by Media Watch that Richard Carleton had plagarised a documentary entitled ’Cry from the Grave'. The article considers the meaning of defamatory imputations, the range of defences, and the available remedies. It highlights the competing arguments over the protection of reputation and privacy, artistic expression, and the freedom of speech. This article concludes that defamation law should foster ’gossip we can trust'.

Are we getting accurate measurements of Ksat for sodic clay soils?

In this paper we discuss the use of a series of column experiments to improve understanding of the effect irrigation water chemistry (saline solutions) has on measurements of saturated hydraulic conductivity (Ksat) of a sodic clay soil. We highlight in particular the use of extended leaching periods to determine whether the duration of leaching affects the results. In the experiments, mixed cation solutions of two different salinity levels, 50 meq/L and 100 meq/L, were applied under constant head to columns of a repacked sodic clay soil using three replicates for each treatment. The maximum Ksat measured during leaching with the 100 meq/L solution was approximately double the maximum Ksat measured during leaching with the 50 meq/L solution. Measured flow rates were found to increase rapidly after flow commenced then decrease gradually until flow rates became stable. The final, stable flow rate was roughly 80% less than the maximum flow rate measured. Reasons for these changes in saturated hydraulic conductivity are discussed. The key finding from these experiments is that long term leaching, involving significantly more pore volumes than is commonly reported in the literature, is required to obtain a ‘stable’ Ksat. We recommend that further studies be carried out to (1) determine whether similar behaviour in Ksat occurs in a wide range of sodic clay soils and (2) to help build a better understanding of the causes and implications of the observed behaviour in Ksat.

We don’t want your must-see TV: Transatlantic television and the failed “Coupling” format

NBC's failed attempt to remake the BBC's Coupling generated a significant amount of press coverage in summer 2003. At the core of the debate was a struggle to reconcile an increasingly integrated transatlantic television market with traditional assumptions about culture and its authentic connection to space and place. The interest in the remake not only created a space where certain national differences were played out and performed but also facilitated an equally compelling transatlantic dialogue about creative ownership, appropriation, and a network's responsibility to its audiences. In doing so, the media attention highlighted how television formats are best understood not as innocuous commodities of international trade but as potential sites of articulation, contestation, and community in an increasingly transnational television environment.

Rio+ 20: The future we want or greenwash?

The Rio+20 United Nations Conference on Sustainable Development featured a fractious debate over intellectual property and the environment. Not only was there heated debate about patent law, technology transfer, and sustainable development, there was also a debate about sustainable public procurement, eco-labelling, accountable advertising, and greenwashing.

Genetics of ankylosing spondylitis and rheumatoid arthritis: Where are we at currently, and how do they compare?

Both ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are common, highly heritable conditions, the pathogenesis of which are incompletely understood. Gene-mapping studies in both conditions have over the last couple of years made major breakthroughs in identifying the mechanisms by which these diseases occur. Considering RA, there is an over-representation of genes involved in TNF signalling and the NFκB pathway that have been shown to influence the disease risk. There is also considerable sharing of susceptibility genes between RA and other autoimmune diseases such as systemic lupus erythematosus, type 1 diabetes, autoimmune thyroid disease and celiac disease, with thus far little overlap with AS. In AS, genes involved in response to IL12/IL23, and in endoplasmic reticulum peptide presentation, have been identified, but a full genomewide association study has not yet been reported.

Are we waiting too long for the cardiovascular outcome trials with the glucagon-like peptide-1 receptor agonists?

Several new medicines are in development for the treatment of type 2 diabetes, and cardiovascular outcome trials are the gold standard for these medicines. This editorial demonstrates that despite being available for over 10 years, there are no cardiovascular outcome studies for any of the glucagon-like peptide-1 (GLP-1) receptor agonists, which demonstrate cardiovascular safety or benefit in subjects with high cardiovascular risk. The author argues that the FDA should be ensuring that clinical outcome studies for subjects with type 2 diabetes and high cardiovascular risk be undertaken in a timelier manner.

After 10 years of clinical trials with liraglutide, do we know whether it is beneficial in diabetes?

Type 2 diabetes remains an escalating world-wide problem, despite a range of treatments. The revelation that insulin secretion is under the control of a gut hormone, glucagon-like peptide 1 (GLP-1), led to a new paradigm in the management of type 2 diabetes. Liraglutide is a long acting GLP-1 receptor agonist used in the treatment of type 2 diabetes. The review considers the clinical trials with liraglutide. There are many comparator trials between liraglutide and other medicines for the treatment of type 2 diabetes, and these trials have shown that liraglutide lowers HbA1c and body weight, and is well tolerated. A large cardiovascular safety trial with liraglutide is presently being undertaken. After 10 years of clinical trials with liraglutide, we do not know whether liraglutide has cardiovascular safety in subjects with type 2 diabetes and high cardiovascular risk. Although this is not a requirement for registration by the Food and Drug Administration (FDA), in my opinion, they should reconsider this. We also do not presently know whether liraglutide has any beneficial effects on clinical cardiovascular outcomes.

A two-stage SVM method to predict membrane protein types by incorporating amino acid classifications and physicochemical properties into a general form of Chou's PseAAC

Membrane proteins play important roles in many biochemical processes and are also attractive targets of drug discovery for various diseases. The elucidation of membrane protein types provides clues for understanding the structure and function of proteins. Recently we developed a novel system for predicting protein subnuclear localizations. In this paper, we propose a simplified version of our system for predicting membrane protein types directly from primary protein structures, which incorporates amino acid classifications and physicochemical properties into a general form of pseudo-amino acid composition. In this simplified system, we will design a two-stage multi-class support vector machine combined with a two-step optimal feature selection process, which proves very effective in our experiments. The performance of the present method is evaluated on two benchmark datasets consisting of five types of membrane proteins. The overall accuracies of prediction for five types are 93.25% and 96.61% via the jackknife test and independent dataset test, respectively. These results indicate that our method is effective and valuable for predicting membrane protein types. A web server for the proposed method is available at http://www.juemengt.com/jcc/memty_page.php

We know this: How to apply what you already know to treat alcohol and other drug problems

Background Implementing effective AOD supports and treatments into our daily practice can occur via a range of strategies. While specialist treatments exclusively targeting pathways toward substance reduction are an option, it is often not within the scope of many psychologists working in generalist or tertiary mental health settings. Regardless of the perceived barriers for integrating AOD practice into our work, there are key principles and approaches that can be adopted to improve the outcomes for many clients. Aim Irrespective of the client’s perceived need to address AOD issues, significant substance use will impact on the development, prognosis and treatment of most mental health conditions. Embedding AOD practice across our clinical work requires an openness to consider evidence-based approaches for all levels of substance use. Method This presentation will outline a series of approaches that all practitioners can adopt, based on the principles of harm reduction and empowerment of client’s choice. An emphasis will be made toward outlining approaches that are consistent with best practice, easily accessible and do not require extensive resources to embed. Conclusion Applying effective AOD treatments as a standard treatment component is achievable for all practitioners and is essential for achieving better outcomes for a high proportion of the community accessing treatment from psychologists.

Introducing the practice of statistics: are we environmentally friendly?

The practice of statistics is the focus of the world in which professional statisticians live. To understand meaningfully what this practice is about, students need to engage in it themselves. Acknowledging the limitations of a genuine classroom setting, this study attempted to expose four classes of year 5 students (n=91) to an authentic experience of the practice of statistics. Setting an overall context of people’s habits that are considered environmentally friendly, the students sampled their class and set criteria for being environmentally friendly based on questions from the Australian Bureau of Statistics CensusAtSchool site. They then analysed the data and made decisions, acknowledging their degree of certainty, about three populations based on their criteria: their class, year 5 students in their school and year 5 students in Australia. The next step was to collect a random sample the size of their class from an Australian Bureau of Statistics ‘population’, analyse it and again make a decision about Australian year 5 students. At the end, they suggested what further research they might do. The analysis of students’ responses gives insight into primary students’ capacity to appreciate and understand decision making, and to participate in the practice of statistics, a topic that has received very little attention in the literature. Based on the total possible score of 23 from student workbook entries, 80 % of students achieved at least a score of 11.

Media business studies as we see it: Why does it matter, for whom, and how do you get published? [editorial]

To the delight of the renewed editorial team, the Journal of Media Business Studies (JOMBS) receives an increasing number of submissions every week. Given the growing interest in the study of media business, whether from the angle of economics, management, strategy, organisation studies, marketing, consumer behaviour, innovation and entrepreneurship or other contributing disciplines, this editorial aims to clarify how we look at the field and wish to move the journal forward. In particular, we want to address a few questions that we believe are central for those who wish to publish their research with us and thereby contribute to the academic discussion. This article gives a more elaborate explanation to the aims and scope of JOMBS.