Molecular wires – impact of π-conjugation and implementation of molecular bottlenecks

We highlight recent progress in the field of electron transport through molecular bridges as integrative parts of electron donor–bridge–acceptor conjugates.

Thermochromic and solvatochromic properties of Lindqvist polyoxometalates

The thermochromic and solvatochromic properties of a family of Lindqvist polyoxometalates are rationalized by experimental and computational methods.

Developing a dancer wellness program employing developmental evaluation

Wellness programs are being increasingly employed with performing artists. Given their aim of reducing injuries, injury tracking is commonly employed as an outcome measure. Evaluating the development and process of a wellness program can also enhance its effectiveness. Developmental evaluation offers one methodological framework within which to conduct such investigations. This paper reports on a 2-year process involving feedback from professional ballet dancers, management and artistic staff, and healthcare providers at a ballet company in order to develop a dancer screening and wellness program. Following a consultation phase, an initial program composed of an expanded medical team and annual injury prevention screen was proposed. Alongside implementation with 30 professional ballet dancers, formal and informal feedback was sought from stakeholders and members across all levels of the ballet company to facilitate ongoing development, evaluation, and revision of the wellness program. The use of a process informed by developmental evaluation helped identify strengths and limitations within the screening process. The collective expertise of the assessors was used to modify the components and process of the screen to strive for ecological appropriateness. The process also fostered buy-in from all involved. Participant feedback helped refine the medical team available to the dancers and influenced the treatment and referral pathways via which dancers are able to access each member of the medical team. Furthermore, reflective discussions with artistic and management staff brought to light potential interactions between repertoire programming, fitness, and injury patterns. This prompted a reconsideration of how artists are trained and supported. Evaluation methods that focus on experiences and insight gained during program development stand to result in more efficient screening programs and health-promotion models and, ultimately, healthier performing artists.

Training for sustained performance: moving toward long-term musician development

Success in the performing arts, like sports, is dependent upon the acquisition and consistent use of a diverse range of skills. In sports, an understanding of safe and effective use of the body is required to facilitate long-term involvement in that activity. In order to assist athletes to attain their performance goals, and ensure healthy and sustained involvement, long-term athlete development (LTAD) models have been devised and adapted by professional sporting bodies throughout the world. LTAD models emphasize the intellectual, emotional, and social development of the athlete, encourage long-term participation in physical activities, and enable participants to improve their overall health and well-being and increase their life-long participation in physical activity. At present there is no such long-term development model for musicians. Yet musicians must cope with a multitude of career-related physical and mental demands, and performance-related injuries and career burnout are rife within the profession. Despite this, musicians' training rarely addresses such issues and musicians are left largely to learn about them through either chance or accrued experience. This paper discusses key concepts and recommendations in LTAD models, together with music-specific research highlighting the need for the development of a comprehensive long-term approach to musicians' training. The results of a survey of existing music training programs are compared to recommendations and the different development stages in LTAD models. Finally, implementation science is introduced as a methodological option for identifying how best to communicate the body of evidence-based knowledge concerning healthy and effective music-making to young student musicians.

The relationship between postural stability and dancer's past and future lower-limb injuries

In an effort to address dance-related injuries, screening programs are typically employed to assess injury susceptibility. The aim of this study was to explore for potential links between postural stability and dancers' previous lower-limb injuries and susceptibility to future lower-limb injuries. Eighty-five contemporary dance students were recruited at a UK dance conservatoire. Information concerning previous injuries was collected by self-report survey. The participants completed two balance tasks, one static and one dynamic, performed on a RS Scan Footscan pressure pad to calculate postural sway. Injuries in the participant cohort were then tracked for a 10-month period to assess injury susceptibility. The participants exhibited significantly less postural sway when balancing on the left leg than their right, and the women exhibited less postural sway than the men. A one-way ANOVA revealed that participants who had experienced a lower-limb injury in the 12 months prior to testing exhibited more postural sway than participants who had not experienced a lower-limb injury, with some of the differences attaining significance (p <0.05). No significant links were found between either postural sway or previous injury and future injury susceptibility. The results suggest that assessments of postural stability via centre of pressure measurements are a reliable method for assessing dancers' balance ability. While reaffirming the importance of comprehensive, multidisciplinary screening programs, the results also highlight the necessity of developing a greater understanding of both dancers and the environments in which they dance and work to fully ascertain injury susceptibility.

Documentation quality and time costs

The Department of Veterans Affairs (VA) performs over 800,000 disability exams and distributes over $37 billion in disability benefits per year. VA developed and deployed a computer-based disability exam documentation system in order to improve exam report quality and timeliness. We conducted a randomized controlled trial comparing joint disability examinations supported by computerized templates to the examinations documented via dictation, to determine if the system met the intended goals or had unintended consequences. Consenting veterans were randomized to undergo exams documented using computerized templates or via dictation. We compared exam report quality, documentation time costs, encounter length, total time to fulfill an exam request with a finalized exam report, and veteran satisfaction. Computer-based templates resulted in disability exam reports that had higher quality scores (p. 0.042) and were returned to the requesting office faster than exam reports created via dictation (p. 0.02).

Documentation time and veteran satisfaction were similar for both the documentation techniques. Encounter length was significantly longer for the template group. Computer-based templates impacted the VA disability evaluation system by improving report quality scores and production time and lengthening encounter times. Oversight bodies have called for mandated use of computer-based templates nationwide. We believe mandates regarding use of health information technology should be guided by data regarding its positive and negative impacts.

A hybrid human and machine resource curation pipeline for the Neuroscience Information Framework

The breadth of information resources available to researchers on the Internet continues to expand, particularly in light of recently implemented data-sharing policies required by funding agencies. However, the nature of dense, multifaceted neuroscience data and the design of contemporary search engine systems makes efficient, reliable and relevant discovery of such information a significant challenge. This challenge is specifically pertinent for online databases, whose dynamic content is ‘hidden’ from search engines. The Neuroscience Information Framework (NIF; http://www.neuinfo.org) was funded by the NIH Blueprint for Neuroscience Research to address the problem of finding and utilizing neuroscience-relevant resources such as software tools, data sets, experimental animals and antibodies across the Internet. From the outset, NIF sought to provide an accounting of available resources, whereas developing technical solutions to finding, accessing and utilizing them. The curators therefore, are tasked with identifying and registering resources, examining data, writing configuration files to index and display data and keeping the contents current. In the initial phases of the project, all aspects of the registration and curation processes were manual. However, as the number of resources grew, manual curation became impractical. This report describes our experiences and successes with developing automated resource discovery and semiautomated type characterization with text-mining scripts that facilitate curation team efforts to discover, integrate and display new content. We also describe the DISCO framework, a suite of automated web services that significantly reduce manual curation efforts to periodically check for resource updates. Lastly, we discuss DOMEO, a semi-automated annotation tool that improves the discovery and curation of resources that are not necessarily website-based (i.e. reagents, software tools). Although the ultimate goal of automation was to reduce the workload of the curators, it has resulted in valuable analytic by-products that address accessibility, use and citation of resources that can now be shared with resource owners and the larger scientific community.

Database URL:http://neuinfo.org

Efficacy and tolerability of methotrexate therapy for refractory Crohn's disease: a large single-centre experience

BACKGROUND

Randomised controlled trials demonstrate that methotrexate is effective in inducing remission and preventing relapse of Crohn's disease (CD) as a first-line immunosuppressant, but efficacy data after failure with, or intolerance to, thiopurines are limited.

AIMS

To report efficacy of methotrexate in a cohort of refractory CD patients, most of whom had not responded to, or were intolerant of, thiopurines.

METHODS

Data were collected for patients receiving methotrexate for active CD. Response to methotrexate induction therapy at 4 months, and sustained clinical benefit at last point of follow-up with maintenance therapy, were assessed via physician's global assessment. Demographic and disease factors predicting response, or sustained clinical benefit, were examined by univariate and multivariate analysis.

RESULTS

Sixty-six [38 (54%) female patients, mean age at diagnosis 29.4 years] patients received methotrexate between 2001 and 2010, 61 (92%) of whom received the drug parenterally. Sixty patients had failed, or were intolerant of, thiopurines. Response to therapy at 4 months occurred in 54 (82%) patients. However, sustained clinical benefit occurred in only 19 (29%) patients at last point of follow-up, including six patients who discontinued the drug for family planning reasons. No predictors of response or sustained clinical benefit were identified. Adverse events occurred in 20 (30%) patients.

CONCLUSIONS

These data suggest that methotrexate is effective in terms of initial response in Crohn's disease patients who have failed, or are intolerant of, thiopurines. However, efficacy is not sustained in the long term.

POMHS 9b - antipsychotic prescribing in people with a learning disability

INTRODUCTION

Prescribing Observatory for Mental Health (POMH-UK) runs national audit-based quality improvement programmes open to all specialist mental health services in the UK to help improve prescribing practice in discrete areas.

AIMS

The baseline sample and this re-audit represent the largest audits of antipsychotic prescribing in PWLD that have been conducted to date; and thus provide the most generalisable picture of such prescribing nationally.

METHODOLOGY

A case note audit of use of antipsychotic medication in PWLD was conducted using standard data collection tool provided by POMH-UK. Trust wide, 7 clinical teams in Essex and Bedfordshire & Luton, participated in the re-audit. Analysis and benchmarking was conducted centrally by POMH-UK and an individualised Trust report was compiled by POMH-UK for local review and consideration.

STANDARDS

The indication for treatment with antipsychotic medication should be documented in the clinical records (Deb 2006). The continuing need for antipsychotic medication should be reviewed at least once a year (Deb 2006). Side effects of antipsychotic medication should be reviewed at least once a year. This review should include assessment for the presence of extrapyramidal side effects (EPS), and screening for the 4 aspects of the metabolic syndrome: obesity, hypertension, impaired glucose tolerance and dyslipidaemia (NICE schizophrenia guideline update CG82, 2009).

FINDINGS

Out of three standards measured, Standard One maintained 100% throughout the baseline and re-audit and Standard Two achieved over 90% throughout baseline and re-audit. Standard 3 has improved from baseline to re-audit. Overall, there has been clear improvement in all 3 standards from baseline audit.