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Motor neuron disease (MND) is a progressive, fatal, neurodegenerative condition that affects motor neurons in the brain and spinal cord, resulting in loss of the ability to move, speak, swallow and breathe. Acceptance and commitment therapy (ACT) is an acceptance-based behavioural therapy that may be particularly beneficial for people living with MND (plwMND). This qualitative study aimed to explore plwMND’s experiences of receiving adapted ACT, tailored to their specific needs, and therapists’ experiences of delivering it.
Method:
Semi-structured qualitative interviews were conducted with plwMND who had received up to eight 1:1 sessions of adapted ACT and therapists who had delivered it within an uncontrolled feasibility study. Interviews explored experiences of ACT and how it could be optimised for plwMND. Interviews were audio recorded, transcribed and analysed using framework analysis.
Results:
Participants were 14 plwMND and 11 therapists. Data were coded into four over-arching themes: (i) an appropriate tool to navigate the disease course; (ii) the value of therapy outweighing the challenges; (iii) relevance to the individual; and (iv) involving others. These themes highlighted that ACT was perceived to be acceptable by plwMND and therapists, and many participants reported or anticipated beneficial outcomes in the future, despite some therapeutic challenges. They also highlighted how individual factors can influence experiences of ACT, and the potential benefit of involving others in therapy.
Conclusions:
Qualitative data supported the acceptability of ACT for plwMND. Future research and clinical practice should address expectations and personal relevance of ACT to optimise its delivery to plwMND.
Key learning aims
(1) To understand the views of people living with motor neuron disease (plwMND) and therapists on acceptance and commitment therapy (ACT) for people living with this condition.
(2) To understand the facilitators of and barriers to ACT for plwMND.
(3) To learn whether ACT that has been tailored to meet the specific needs of plwMND needs to be further adapted to potentially increase its acceptability to this population.
Contemporary understanding of the mechanisms of disease increasingly points to examples of “genetic diseases” with an infectious component and of “infectious diseases” with a genetic component. Such blurred boundaries generate ethical, legal, and social issues and highlight historical contexts that must be examined when incorporating host genomic information into the prevention, outbreak control, and treatment of infectious diseases.
The article sheds light on the proposition that labour is a commodity by considering from a fundamental theoretical perspective whether labour is subject to the same market forces which apply to commodities in general in capitalist economies. It suggests that no spontaneous competitive force exists within capitalism that would adjust labour demand to its supply, in contrast to the adaptation of supply to the demand for commodities in general. This result is argued without reference to assumptions about inflexibilities or impediments in labour or other markets, or institutional features peculiar to ‘the labour market’. Its explanation of why labour markets do not clear is at odds with a core tenet underlying orthodox economic theory of the last century, which has acted as a fundamental benchmark for most theorising about labour to the present day. Rejection of this tenet is at the heart of a heterodox explanation of unemployment, the real wage and income distribution in capitalist economies.
This paper focuses on utilizing several different optical diagnostics to experimentally characterize a pure helium atmospheric pressure plasma jet. Axial electric field measurements were carried out along the plasma plume through the use of a non-perturbing method based on polarization-dependent Stark spectroscopy of the helium $492.2$ nm line. The electric field is shown to increase with distance along the plume length, reaching values as high as $24.5$ kV cm$^{-1}$. The rate of increase of the electric field is dependent on the helium gas flow rate, with lower gas flows rising quicker with distance in comparison with larger flow rates, with the typical values remaining within the same range. This sensitivity is linked to gas mixing between the helium and surrounding ambient air. Schlieren imaging of the gas flow is included to support this. The addition of a target is shown to further increase the measured electric field in close range to the target, with the magnitude of this increase being strongly dependent on the distance between the tube exit and target. The relative increase in the electric field is shown to be on average greater for a conducting target of water in comparison with plastic. A minimal equipment optical configuration, which is here referred to as fast two-dimensional monochromatic imaging, is introduced as an approach for estimating excited state densities within the plasma. Densities of the upper helium states for transitions, $1s3s$$^{3}S_{1}$$\rightarrow$$1s2p$$^{3}P^{0}_{0,1,2}$ at $706.5$ nm and $1s3s$$^{1}S_{0}$$\rightarrow$$1s2p$$^{1}P^{0}_{1}$ at $728.1$ nm, were estimated using this approach and found to be of the order of $10^{10}$–$10^{11}$ cm$^{-3}$.
To evaluate infectious pathogen transmission data visualizations in outbreak publications.
Design:
Scoping review.
Methods:
Medline was searched for outbreak investigations of infectious diseases within healthcare facilities that included ≥1 data visualization of transmission using data observable by an infection preventionist showing temporal and/or spatial relationships. Abstracted data included the nature of the cluster(s) (pathogen, scope of transmission, and individuals involved) and data visualization characteristics including visualization type, transmission elements, and software.
Results:
From 1,957 articles retrieved, we analyzed 30 articles including 37 data visualizations. The median cluster size was 20.5 individuals (range, 7–1,963) and lasted a median of 214 days (range, 12–5,204). Among the data visualization types, 10 (27%) were floor-plan transmission maps, 6 (16%) were timelines, 11 (30%) were transmission networks, 3 (8%) were Gantt charts, 4 (11%) were cluster map, and 4 (11%) were other types. In addition, 26 data visualizations (70%) contained spatial elements, 26 (70%) included person type, and 19 (51%) contained time elements. None of the data visualizations contained contagious periods and only 2 (5%) contained symptom-onset date.
Conclusions:
The data visualizations of healthcare-associated infectious disease outbreaks in the systematic review were diverse in type and visualization elements, though no data visualization contained all elements important to deriving hypotheses about transmission pathways. These findings aid in understanding the visualizing transmission pathways by describing essential elements of the data visualization and will inform the creation of a standardized mapping tool to aid in earlier initiation of interventions to prevent transmission.
Community-based participatory research (CBPR) is an approach that empowers marginalized groups to become partners in research. However, CBPR can be challenging to implement and has been underutilized in research on substance use disorder (SUD). The goal of this chapter is to provide practical knowledge and resources for individuals who wish to implement CBPR projects related to the stigma of SUD. In this chapter, we define CBPR, apply principles of CBPR to a case example, and suggest ways that community members can be directly involved in research on SUD stigma. We consider how CBPR might address gaps in research on the stigma of SUD and provide guidelines to engaging stakeholders in CBPR. Drawing from the literature on other health stigmatized health conditions, we present issues to consider during implementation of CBPR projects and models that can guide CBPR work.
The push to implement Open Access (OA) as the new standard for academic research dissemination is creating very real pressures on academic journals. In Canada, the Social Science and Humanities Research Council (SSHRC) recently adopted a policy requiring that journals applying for its Aid to Scholarly Journals (ASJ) grant make their scholarly content freely accessible after no more than a 12-month delay. For journals such as the Canadian Journal of Political Science (CJPS) that not only publish high-quality, peer-reviewed articles to a specialized audience but also support the work of scholarly associations through the revenues they generate, the push to move to OA comes with a number of challenges. The Canadian Political Science Association (CPSA) and the Société québécoise de science politique (SQSP) established a committee to chart the best course of action for the CJPS in light of this changing landscape. This article summarizes the key findings of the committee and underscores some of the challenges of OA for journals with a profile similar to the CJPS, as well as for the broader research ecosystem that they support.
Compared to younger age groups, older people spend more time in their locality and rely more heavily on its pedestrian and public transport infrastructure. Qualitative studies provide unique insight into people's experiences. We conducted a qualitative evidence synthesis of United Kingdom-based studies of older people's experiences of travelling in the urban environment. We searched health, social science, age-related and transport-related databases from 1998 to 2017. Fourteen papers (from 12 studies) were included in a thematic synthesis, a three-staged process that moves iteratively between codes, descriptive themes and cross-cutting analytical themes. Emerging themes were discussed with policy advisers. Four overarching themes were identified. The first and second theme pointed to the importance of ‘getting out’ and of being independent travellers. The third and fourth themes highlighted how local environments and travel systems enabled (or prevented) older people from realising these valued dimensions of travel. The loss of local amenities and micro-environmental features, such as pavement quality, personal safety and aesthetic appearance, were recurrent concerns. Free modes of travel like walking and bus travel were highly valued, including the social engagement they facilitated. Our review suggests that, while its extrinsic value (reaching destinations) matters, the intrinsic value of travel matters too. The process of travel is experienced and enjoyed for its own sake, with older people describing its contribution to their wellbeing.
May I say how glad I am to have this opportunity of speaking to you on a subject to which I, and others, have devoted so much time and thought. Not that any of us have ever begrudged this time or labour. Far from it. I myself, after twelve years as a student of aeronautics, cannot look back on any period when, even for a moment, I have wearied in my task. And indeed the more I study this subject the more convinced I am h*^w well worth while it is for us, now, to devote all the time we can to this question of commercial aeronautics. It is a subject which is something much more than purely commercial. It is not only national but also Imperial. It is something even more than both of these; it is a question which affects the development, happiness, and peace of the entire world. When, with the growing speed of aerial transport, we shall be able to dine in New York one evening and in London the next; when no part of the earth—surface, however remote, is more than a week's journey from London by air, then I think we may say that the coming of this aerial age will do more for the world than any other invention or discovery man has ever made.
This article surveys the first five decades of the Journal/Revue, with particular emphasis on patterns of change and continuity. The article presents a quantitative analysis of the articles published in the Journal/Revue, looking at, among other things, the balance of articles published in English and in French, the proportion of articles authored by women, the location and institutional affiliation of authors and the subject matter of published articles. Significant continuities emerge from the data, such as the predominance of Canadian-based authors writing on aspects of Canadian politics and the dominance of authors from large research-intensive universities. Yet change is also evident, for example in the number of women publishing in the Journal/Revue and in the emergence of articles in subfields not found in the Journal/Revue’s earlier days, most notably Aboriginal politics, gender and politics, and race and ethnicity.
For institutions as well as for people, turning 50 invites reflection on what's gone before and what's to come. This special 50th anniversary issue looks at Canadian political science and the profession—past and present—from a number of perspectives and explores ways in which they might or should change.
A common sunflower population from Howard, SD (HSD) was previously determined to be cross-resistant to imazethapyr and chlorimuron-ethyl, both acetolactate synthase–inhibiting (ALS) herbicides. Experiments were conducted to determine if target-site polymorphisms could act as a mechanism of ALS-inhibitor herbicide resistance in the HSD common sunflower. Approximately 1,600 nucleotides were amplified by polymerase chain reaction and sequenced from putative ALS gene(s) in common sunflower and Jerusalem artichoke. In sunflower, two different amplification products were detected that differed by a nine-basepair deletion. This suggested the presence of at least two ALS genes in common sunflower that could contribute to the herbicide resistance phenotype. In addition, an Ala205 to Val205 substitution was observed in several clones from resistant common sunflower (amino acid position is relative to the full-length mouse-ear cress ALS protein). Previously documented mutations at this position in other species indicated that it might play a vital role in conferring resistance to one or more ALS-inhibitor herbicides.
Long-range temporal choices are built into contemporary policy-making, with policy decisions having consequences that play out across generations. Decisions are made on behalf of the public who are assumed to give much greater weight to their welfare than to the welfare of future generations. The paper investigates this assumption. It briefly discusses evidence from sociological and economic studies before reporting the findings of a British survey of people's intergenerational time preferences based on a representative sample of nearly 10,000 respondents. Questions focused on two sets of policies: (i) health policies to save lives and (ii) environmental policies to protect against floods that would severely damage homes, businesses and other infrastructure. For both sets of policies, participants were offered a choice of three policy options, each bringing greater or lesser benefits to their, their children's and their grandchildren's generations. For both saving lives and protecting against floods, only a minority selected the policy that most benefited their generation; the majority selected policies bringing equal or greater benefits to future generations. Our study raises questions about a core assumption of standard economic evaluation, pointing instead to concern for future generations as a value that many people hold in common.
Hyperekplexia is a rare disorder caused by autosomal dominant or recessive modes of inheritance and characterized by episodes of exaggerated startle. Five causative genes have been identified to date. The syndrome has been recognized for decades and due to its rarity, the literature contains mostly descriptive reports, many early studies lacking molecular genetic diagnoses. A spectrum of clinical severity exists. Severe cases can lead to neonatal cardiac arrest and death during an episode, an outcome prevented by early diagnosis and clinical vigilance. Large treatment studies are not feasible, so therapeutic measures continue to be empiric. A marked response to clonazepam is often reported but refractory cases exist. Herein we report the clinical course and treatment response of a severely affected infant homozygous for an SLC6A5 nonsense mutation and review the literature summarizing the history and genetic understanding of the disease as well as the described comorbidities and treatment options.
Herbert Howells (1892-1983) was a prodigiously gifted musician and the favourite student of the notoriously hard-to-please Sir Charles Villiers Stanford. Throughout his long life, he was one of the country's most prominent composers, writing extensively in all genres except the symphony and opera. Yet today he is known mostly for his church music, and there is as yet relatively little serious study of his work. This book is the first large-scale study of Howells's music, affording both detailed consideration of individual works and a broad survey of general characteristics and issues. Its coverage is wide-ranging, addressing all aspects of the composer's prolific output and probing many of the issues that it raises. The essays are gathered in five sections: Howells the Stylist examines one of the most striking aspect of the composer's music, its strongly characterised personal voice; Howells the Vocal Composer addresses both his well-known contribution to church music and his less familiar, but also important, contribution to the genre of solo song; Howells the Instrumental Composer shows that he was no less accomplished for his work in genres without words, for which, in fact, he first made his name; Howells the Modern considers the composer's rather overlooked contribution to the development of a modern voice for British music; and Howells in Mourning explores the important impact of the death of Michael on his father's life and work. The composer that emerges from these studies is a complex figure: technically fluent but prone to revision and self-doubt; innovative but also conservative; a composer with an improvisational sense of flow who had a firm grasp of musical form; an exponent of British musical style who owed as much to continental influence as to his national heritage. This volume, comprising a collection of outstanding essays by established writers and emergent scholars, opens up the range of Howells's achievement to a wider audience, both professional and amateur. PHILLIP COOKE is Lecturer in Composition at the University of Aberdeen. DAVID MAW is Tutor and Research Fellow in Music at Oriel College, Oxford, holding Lectureships also at Christ Church, The Queen's and Trinity Colleges. CONTRIBUTORS: Byron Adams, Paul Andrews, Graham Barber, Jonathan Clinch, Phillip Cooke, Jeremy Dibble, Lewis Foreman, Fabian Huss, David Maw, Diane Nolan-Cooke, Lionel Pike, Paul Spicer, Jonathan White. Foreword by John Rutter.
Edited by
Phillip A. Cooke, Lecturer in Composition at the University of Aberdeen,David Maw, Tutor and Research Fellow in Music at Oriel College, Oxford, holding Lectureships also at Christ Church, The Queen's and Trinity Colleges
‘What humanity can endure and suffer is beyond belief’.
Sir Edwin Lutyens, letter of 12 July 1917
An horrible story: one that causes sickening knots of dread to tighten in the pit of any loving parent's stomach. The events unfold simply, inexorably, as if the chill hand of the Erlkönig guided the tragedy. A family is on holiday in Gloucestershire when the youngest child, a bright, resolute, and charming little boy, falls ill. A local doctor is summoned, makes an accurate diagnosis and urges the family to return to London as quickly as possible. On the ride to the train station and on the train hurtling through the darkening countryside, the gasping child, held by his powerless father, struggles to breathe, turning blue and black from lack of oxygen, a sure sign of bulbar poliomyelitis. On arrival in London, an ambulance rushes the little boy to a nursing home; as the doctors debate about what to do – an iron lung, perhaps? – the child proves their irrelevance by dying. The boy, named Michael, left behind a father immured in a grief that time did not assuage; a mother whose feelings were doubtless keen but went virtually unnoticed; and an older sister whose secondary place in her father's affections would be felt again and ever again in the decades to come.