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People living with stroke and neurological conditions access rehabilitation at different times but self-management is often viewed as what happens post-discharge. Personalised models that integrate self-management support within everyday care are now advocated but this may require practitioners to change their behaviour to adopt and sustain new ways of working. The People1st project evaluated integration of an existing Supported Self-Management programme ("Bridges") across varied stroke and neurorehabilitation service contexts.Mixed-method evaluation of training for groups of healthcare practitioners across 24 UK National Health Service (NHS) Trusts, exploring how learning from Bridges was assimilated and enacted in practice, on an individual and collective basis.Staff growth in confidence and skill around supported self-management was demonstrated. Transformations to practice included changes to: the structure of, and language used in, patient interactions; induction/training processes to increase potential for sustainability; and sharing of successes. Bridges helped practitioners make changes that brought them closer to their professional ideals. Engaged leadership was considered important for successful integration.Bridges was successfully integrated within a wide range of stroke and neurorehabilitation service contexts, enabled by an approach in line with practitioners' values-based motivations. Further work is required to explore sustainability and impact on service users. Implications for rehabilitationPersonalised models of care and support for self-management are advocated for people living with stroke and neurological conditions; this requires practitioners to be supported to change behaviour and practices to adopt and sustain new ways of working.Staff from a wide variety of backgrounds in neurorehabilitation and stroke can learn collaboratively about self-management practices via the Bridges programme and can integrate those practices into their service contexts.Bridges can take practitioners closer to their professional ideals of caring and making a difference and empowers them to initiate change.Organisational commitment and engaged leadership are required to facilitate a culture of support for self-management in practice.

This study explores the impact of post-earthquake images inserted in a vigilance task, in terms of performance, self-reports of task-focus, and cerebral activity using functional near-infrared spectroscopy (fNIRS). Vigilance tasks present a sequence of stimuli in which only a few are pre-designated critical or target stimuli requiring an overt response from the participant. Seventy-one residents participated (51 women, 20 men) by taking part in a vigilance task with task-irrelevant images inserted in the sequence. There were three conditions consisting positive (emotive inducing), negative (emotive inducing), and control (devoid of meaning) images embedded in the vigilance task to assess possible impacts on vigilance performance. The images were obtained through crowdsourcing and represented parts of the city 3-4 years post-earthquake. Task performance was assessed with signal detection theory metrics of sensitivity A' and bias β''. This enables the separation of an individual's ability to accurately discriminate critical signals from non-critical stimuli (sensitivity) and shifts in their willingness to respond to any stimuli whether critical or not (bias). Individuals viewing the positive images, relating to progress, rebuild, or aesthetic aspects within the city, had a more conservative response bias (they responded less to both rare critical and distractor stimuli) than those in the other conditions. These individuals also reported lower task-focus, as would be expected. However, contrary to expectations, indicators of cerebral activity (fNIRS) did not differ significantly between the experimental groups. These results, when combined, suggest that mind wandering events may be being generated when exposed to positive post-earthquake images.

To assess the possibility that acute caffeine's behavioral action might depend on rats' strain, effects of 50mg/kg of the drug were observed on activity, anxiety-related behavior and habituation learning in male and female rats from three different strains, namely PVG/c, Long-Evans and Wistar. All subjects were tested in an open field, an elevated plus maze and a light-dark box. For the three strains combined, increased occupancy of the center of the open field and entries of the open plus-maze arms with caffeine suggested caffeine-induced anxiolysis, whereas increased grooming in the open field, decreased rearing in the plus maze and increased risk assessment in the light-dark box were consistent with anxiogenesis. Caffeine also reduced open-field rearing only for PVG/c rats, and entries into and occupation of the light side of the light-dark box only for Long-Evans rats, and increased total defecation in the three types of apparatus for all three strains combined. Overall, caffeine appeared to be mainly anxiogenic. The drug also increased open-field ambulation for PVG/c rats and walking for all rats, but decreased open-field ambulation and entries into the plus maze closed arms for Wistar rats alone. In general, Wistar rats appeared to be the least and Long-Evans the most anxious of the three strains investigated. Caffeine also decreased within-session habituation of open-field ambulation for PVG/c rats alone, thereby suggesting strain-dependent interference with non-associative learning and short-term memory. Several overall sex differences were also observed that supported female rats being more active and less anxious than males.

For 20days male and female PVG/c hooded rats were provided with caffeinated (approximately 50mg/kg/day) or unadulterated drinking water, and then their anxiety-related behavior was observed in an open field and elevated plus maze. Their choices of a brightness change were also observed in a Y maze to assess any caffeine effects on spatial memory. 24h later, all rats were tested again following an intraperitoneal injection of 50mg/kg acute caffeine, or vehicle. Earlier chronic caffeine decreased ambulation, walking, rearing, center occupancy and increased immobility in the open field thereby suggesting increased anxiety. However, occupancy of the plus-maze open arms and the Y-maze novel arm were increased by caffeine for male rats, but decreased for females probably because of sex differences in control levels of the response rather than to drug effects on anxiety and memory respectively. Following caffeine withdrawal, acute caffeine had the opposite effect to chronic treatment namely, increased open-field ambulation, walking, center occupancy and decreased immobility and defecation for caffeine-naive rats that were suggestive of decreased anxiety. Similar but more consistent effects (plus decreased emergence latencies from a darkened start box into the open field) also typified the caffeine-experienced rats which in this case may have been accentuated by caffeine withdrawal-reversal. There was no evidence of either chronic or acute caffeine affecting spatial memory measured in the Y maze. There were also examples of lower overall activity and higher anxiety in male rats, than in females, and some sex-dependent caffeine effects.

Male and female PVG/c rats were observed in an open field (OF) and an elevated plus maze (EPM) either with or without a bright light stressor (600-692 lx) following an intraperitoneal injection of saline, 25 or 50mg/kg of caffeine. One week later, the same rats were observed under the same drug and lighting conditions but in the opposite apparatus to that experienced earlier. Either the higher or both doses of caffeine decreased anxiety as indicated by increased OF rearing and decreased grooming, immobility and corner occupancy (in the presence of bright light). A similar interpretation applied to caffeine-related increased entries into and observations in the EPM open arms for males only, and increased entries into the open arms for females alone in the presence of bright light. Bright light increased anxiety as shown by longer latencies of emergence into the OF and decreased ambulation and, for males only, decreased center occupancy and increased corner occupancy. Fewer entries into the open arms in the presence of bright light for females only also suggested heightened anxiety. Apart from one OF and one EPM measure, bright light did not appear to markedly influence the effects of caffeine which were concluded to be primarily anxiolytic, with males being more affected than females. Although the central mechanisms responsible for caffeine's anxiolytic action remain to be established, it is possible that antagonism of A2A adenosine receptors might somehow be involved.

To investigate a possible dose-response relationship and sex differences for anxiolytic and memory-enhancing effects of ascorbic acid (vitamin C), an adult PVG /c hooded rats were individually treated for 8 weeks with