Predicting long-term outcome after acute ischemic stroke: a simple index works in patients from controlled clinical trials

Background and Purpose—An early and reliable prognosis for recovery in stroke patients is important for initiation of individual treatment and for informing patients and relatives. We recently developed and validated models for predicting survival and functional independence within 3 months after acute stroke, based on age and the National Institutes of Health Stroke Scale score assessed within 6 hours after stroke. Herein we demonstrate the applicability of our models in an independent sample of patients from controlled clinical trials. Methods—The prognostic models were used to predict survival and functional recovery in 5419 patients from the Virtual International Stroke Trials Archive (VISTA). Furthermore, we tried to improve the accuracy by adapting intercepts and estimating new model parameters. Results—The original models were able to correctly classify 70.4% (survival) and 72.9% (functional recovery) of patients. Because the prediction was slightly pessimistic for patients in the controlled trials, adapting the intercept improved the accuracy to 74.8% (survival) and 74.0% (functional recovery). Novel estimation of parameters, however, yielded no relevant further improvement. Conclusions—For acute ischemic stroke patients included in controlled trials, our easy-to-apply prognostic models based on age and National Institutes of Health Stroke Scale score correctly predicted survival and functional recovery after 3 months. Furthermore, a simple adaptation helps to adjust for a different prognosis and is recommended if a large data set is available. (Stroke. 2008;39:000-000.)

Rail passenger crowding, stress, health and safety in Britain

There has long been a question as to whether crowding in rail passenger transport poses a threat to passenger health related to the experience of stress. A review of the scientific literature was conducted. Little rail-specific empirical research was identified. The more general research that does exist suggests that high-density environments are not necessarily perceived as crowded and that stress-related physiological, psychological and behavioural reactions do not necessarily follow from exposure to such environments. Several factors are identified that may moderate the impact of a high-density environment on perceptions of crowding and the subsequent experience and effects of stress. These include, inter alia, perceptions of control and predictability of events. However, if caused, the experience and effects of stress may be made worse by inadequate coach design that gives rise to discomfort. The model that emerges from these findings offers a suitable framework for the development of research questions that should help translate emerging knowledge into practical interventions, for the reduction of any adverse health outcomes associated with crowding.

Coarse-graining and renormalisation group methods for the elucidation of the kinetics of complex nucleation and growth processes

We review our work on generalisations of the Becker-Doring model of cluster-formation as applied to nucleation theory, polymer growth kinetics, and the formation of upramolecular structures in colloidal chemistry. One valuable tool in analysing mathematical models of these systems has been the coarse-graining approximation which enables macroscopic models for observable quantities to be derived from microscopic ones. This permits assumptions about the detailed molecular mechanisms to be tested, and their influence on the large-scale kinetics of surfactant self-assembly to be elucidated. We also summarise our more recent results on Becker-Doring systems, notably demonstrating that cross-inhibition and autocatalysis can destabilise a uniform solution and lead to a competitive environment in which some species flourish at the expense of others, phenomena relevant in models of the origins of life.

Lindano vs. cipermetrina en el tratamiento de la pediculosis capitis

Se presentan los resultados de un estudio comparativo cuasi experimental de tipo clínico y a doble ciego, entre Lindano y Cipermetrina, en el tratamiento de la pediculosis cápitis, realizado en 150 niños de la Parroquia rural de Tarqui, de la escuela Alfonso Moreno Mora, en el que intervinieron 75 pacientes que corresponden al 50 por ciento, tratados con Lindano, y 75 pacientes que corresponden al 50 por ciento, tratados con Cipermetrina. En la muestra estuvieron presentes los siguiente diagnósticos: Pacientes con Liendres 81 que corresponden al 54 por ciento, pacientes con piojos 1 el 0.7 por ciento y pacientes con piojos y Liendres 68 que representan el 45.3 por ciento. Además se valoraron varios aspectos entre los cuales destacan: 1] El número de aplicaciones que necesitaron los niños para curar con cipermetrina y Lindano: Primera aplicación con Cipermetrina curaron 65, que representa el 43.33 por ciento, con Lindano 40 el 26.66 por ciento, segunda aplicación con Cipermetrina 10 el 6.67 por ciento, y con Lindano 34 el 22.67 por ciento, y tercera aplicación con Lindano 1 niño el 0.67 por ciento. 2) Efectos colaterales tales como: Lindano: a] Conjuntivitis: 2 niños 1.34 por ciento, b] Dermatitis: 5 niños 3.33 por ciento; Cipermetrina: a] Dermatitis: 2 niños el 1.33 por ciento

Ontogeny and nutritional programming of mitochondrial proteins in the ovine kidney, liver and lung

This study investigated the developmental and nutritional programming of two important mitochondrial proteins, namely voltage dependent anion channel (VDAC) and cytochrome c in the sheep kidney, liver and lung. The effect of maternal nutrient restriction between early to mid gestation (i.e. 28 to 80 days gestation, the period of maximal placental growth) on the abundance of these proteins was also examined in fetal and juvenile offspring. Fetuses were sampled at 80 and 140 days gestation (term ~147 days), and postnatal animals at 1 and 30 days and 6 months of age. The abundance of VDAC peaked at 140 days gestation in the lung, compared with 1 day after birth in the kidney and liver, whereas cytochrome c abundance was greatest at 140 days gestation in the liver, 1 day after birth in the kidney and 6 months of age in lungs. This differential ontogeny in mitochondrial protein abundance between tissues was accompanied with very different tissue specific responses to changes in maternal food intake. In the liver, maternal nutrient restriction only increased mitochondrial protein abundance at 80 days gestation, compared with no effect in the kidney. In contrast, in the lung mitochondrial protein abundance was raised near to term, whereas VDAC abundance was decreased by 6 months of age. These findings demonstrate the tissue specific nature of mitochondrial protein development that reflects differences in functional adaptation after birth. The divergence in mitochondrial response between tissues to maternal nutrient restriction early in pregnancy further reflects these differential ontogeny’s.

Order fulfillment in high variety production environments

Providing high levels of product variety and product customization is challenging for many companies. This paper presents a new classification of production and order fulfillment approaches available to manufacturing companies that offer high variety and/or product customization. Six categories of approaches are identified and described. An important emerging approach - open pipeline planning – is highlighted for high variety manufacturing environments. It allows a customer order to be fulfilled from anywhere in the system, enabling greater responsiveness in Build-to-Forecast systems. The links between the open pipeline approach, decoupling concepts and postponement strategies are discussed and the relevance of the approach to the volume automotive sector is highlighted. Results from a simulation study are presented illustrating the potential benefits when products can be reconfigured in an open pipeline system. The application of open pipeline concepts to different manufacturing domains is discussed and the operating characteristics of most relevance are highlighted. In addition to the automotive, sectors such as machinery and instrumentation, computer servers, telecommunications and electronic equipment may benefit from an open pipeline planning approach. When properly designed these systems can significantly enhance order fulfillment performance.

The Definition of Curriculum Areas in Occupational Health Psychology

Across the international educational landscape, numerous higher education institutions (HEIs) offer postgraduate programmes in occupational health psychology (OHP). These seek to empower the next generation of OHP practitioners with the knowledge and skills necessary to advance the understanding and prevention of workplace illness and injury, improve working life and promote healthy work through the application of psychological principles and practices. Among the OHP curricula operated within these programmes there exists considerable variability in the topics addressed. This is due, inter alia, to the youthfulness of the discipline and the fact that the development of educational provision has been managed at the level of the HEI where it has remained undirected by external forces such as the discipline’s representative bodies. Such variability makes it difficult to discern the key characteristics of a curriculum which is important for programme accreditation purposes, the professional development and regulation of practitioners and, ultimately, the long-term sustainability of the discipline. This chapter has as its focus the imperative for and development of consensus surrounding OHP curriculum areas. It begins by examining the factors that are currently driving curriculum developments and explores some of the barriers to such. It then reviews the limited body of previous research that has attempted to discern key OHP curriculum areas. This provides a foundation upon which to describe a study conducted by the current authors that involved the elicitation of subject matter expert opinion from an international sample of academics involved in OHP-related teaching and research on the question of which topic areas might be considered important for inclusion within an OHP curriculum. The chapter closes by drawing conclusions on steps that could be taken by the discipline’s representative bodies towards the consolidation and accreditation of a core curriculum.

MATCH: a new industry-focused approach to medical device development

MATCH (Multidisciplinary Assessment of Technology Centre for Healthcare) is a new collaboration in the UK that aims to support the healthcare sector by creating methods to assess the value of medical devices from concept through to mature product. A major aim of MATCH is to encourage the inclusion of the user throughout the product lifecycle in order to achieve devices that truly meet the requirements of their users. A review of the published literature indicates that user requirements are mainly collected during the design and evaluation stage of the product lifecycle whilst other areas, including the concept stage, have less user involvement. Complementing the literature review is an in-depth consultation with the medical device industry, which has identified a number of barriers encountered by companies when attempting to capture user requirements. These will be addressed by a number of case study projects, performed in collaboration with our industrial partners, that will examine the application and utility of different approaches to collecting and analysing data on user requirements. MATCH is focused on providing advice to device developers on how to select and apply methods that have maximum theoretical strength, practical application, cost-effectiveness and likelihood of wide sector acceptance. Feedback will be sought in order to ensure that the needs of the diverse medical device sector are met.

Theory and language of climate change communication

Climate change communication has become a salient topic in science and society. It has grown to be something like a booming industry alongside more established ‘communication enterprises’, such as health communication, risk communication, and science communication. This article situates the theory of climate change communication within theoretical developments in the field of science communication. It discusses the importance and difficulties inherent in talking about climate change to different types of publics using various types of communication tools and strategies. It engages with the difficult issue of the relationship between climate change communication and behavior change, and it focuses, in particular, on the role of language (metaphors, words, strategies, frames, and narratives) in conveying climate change issues to stakeholders. In the process, it attempts to provide an overview of emerging theories of climate change communication, theories that recently have begun to proliferate quite dramatically. In some cases, we can, therefore only provide signposts to the most relevant research that is being carried out with regard to climate change communication without being able to engage with all its aspects. We end with an assessment of how communication could be improved in light of the theories and practices discussed in this article.

The ins and outs of biosecurity: bird 'flu in East Anglia and the spatial representation of risk

Avian influenza, or 'bird 'flu' arrived in Norfolk in April 2006 in the form of the low pathogenic strain H7N3. In February 2007 a highly pathogenic strain, H5N1, which can pose a risk to humans, was discovered in Suffolk. We examine how a local newspaper reported the outbreaks, focusing on the linguistic framing of biosecurity. Consistent with the growing concern with securitisation among policymakers, issues were discussed in terms of space (indoor–outdoor; local–global; national–international) and flows (movement, barriers and vectors) between spaces (farms, sheds and countries). The apportioning of blame along the lines of 'them and us'– Hungary and England – was tempered by the reporting on the Hungarian operations of the British poultry company. Explanations focused on indoor and outdoor farming and alleged breaches of biosecurity by the companies involved. As predicted by the idea of securitisation, risks were formulated as coming from outside the supposedly secure enclaves of poultry production.

Threshold behaviour and final outcome of an epidemic on a random network with household structure

This paper considers a stochastic SIR (susceptible-infective-removed) epidemic model in which individuals may make infectious contacts in two ways, both within 'households' (which for ease of exposition are assumed to have equal size) and along the edges of a random graph describing additional social contacts. Heuristically-motivated branching process approximations are described, which lead to a threshold parameter for the model and methods for calculating the probability of a major outbreak, given few initial infectives, and the expected proportion of the population who are ultimately infected by such a major outbreak. These approximate results are shown to be exact as the number of households tends to infinity by proving associated limit theorems. Moreover, simulation studies indicate that these asymptotic results provide good approximations for modestly-sized finite populations. The extension to unequal sized households is discussed briefly.

Carbon reduction activism in the UK: lexical creativity and lexical framing in the context of climate change

This article examines discourses associated with a new environmental movement, “Carbon Rationing Action Groups” (CRAGs). This case study is intended to contribute to a wider investigation of the emergence of a new type of language used to debate climate change mitigation. Advice on how to reduce one's “carbon footprint,” for example, is provided almost daily. Much of this advice is framed by the use of metaphors and “carbon compounds”—lexical combinations of at least two roots—such as “carbon finance” or “low carbon diet.” The study uses a combination of tools from frame analysis and lexical pragmatics within the general framework of ecolinguistics to compare and contrast language use on the CRAGs' website with press coverage reporting on them. The analysis shows how the use of such lexical carbon compounds enables and facilitates different types of metaphorical frames such as dieting, finance and tax paying, war time rationing, and religious imperatives in the two corpora.

Compounds, creativity and complexity in climate change communication: the case of ‘carbon indulgences’

This article deals with climate change from a linguistic perspective. Climate change is an extremely complex issue that has exercised the minds of experts and policy makers with renewed urgency in recent years. It has prompted an explosion of writing in the media, on the internet and in the domain of popular science and literature, as well as a proliferation of new compounds around the word ‘carbon’ as a hub, such as ‘carbon indulgence’, a new compound that will be studied in this article. Through a linguistic analysis of lexical and discourse formations around such ‘carbon compounds’ we aim to contribute to a broader understanding of the meaning of climate change. Lexical carbon compounds are used here as indicators for observing how human symbolic cultures change and adapt in response to environmental threats and how symbolic innovation and transmission occurs.