Media(ted) fabrications: How the science-media symbiosis helped ‘sell’ cord banking

This paper considers the problematic role of the science–media symbiosis in the dissemination of misleading and emotionally manipulative information regarding services offered by CordBank, New Zealand's only umbilical cord blood banking facility. As this case study illustrates, the growing reliance of health and science reporters on the knowledge capital of medical specialists, biogenetic researchers, and scientists potentially enhances the ability of ‘expert’ sources to set the agenda for media representations of emerging medical and scientific developments, and may undermine the editorial independence of journalists and editors, many of whom in this case failed to critically evaluate deeply problematic claims regarding the current and future benefits of cord banking. Heavy reliance on established media frames of anecdotal personalization and technoboosterism also reinforced a proscience journalistic culture in which claims by key sources were uncritically reiterated and amplified, with journalistic assessments of the value of cord banking emphasizing potential benefits for individual consumers. It is argued that use of these media frames potentially detracts from due consideration of the broader social, ethical, legal, and health implications of emerging biomedical developments, along with the professional, personal, and increasingly also financial interests at stake in their public promotion, given the growing commercialization of biogenetic technologies

Self-Reported Physical Activity Using the International Physical Activity Questionnaire (IPAQ) in Australian Adults with Type 2 Diabetes, with and Without Peripheral Neuropathy

Objective: The aim of this study was to survey the level of self-reported physical activity in people with type 2 diabetes, with and without peripheral neuropathy. Methods: A sample of South Australian adults (n=481) aged 33-88 years with type 2 diabetes, including 55 people with peripheral neuropathy, completed the International Physical Activity Questionnaire (IPAQ). Levels of self-reported physical activity were compared between those with and without peripheral neuropathy. Results: People with type 2 diabetes and peripheral neuropathy (Mdn =1433, IQR = 495–3390 MET.min/wk) were less physically active than those without peripheral neuropathy (Mdn =2106, IQR = 876–4380 MET.min/wk) (p = 0.04). A total of 49% of people with type 2 diabetes and peripheral neuropathy met physical activity recommendations of 150 minutes of at least moderate activity per week, compared to 57% of people with type 2 diabetes alone. Conclusions: These findings demonstrate that people with type 2 diabetes and peripheral neuropathy reported being significantly less active than people with type 2 diabetes alone. People with type 2 diabetes and peripheral neuropathy need to be encouraged to perform higher levels of physical activity for biological, physical and psychological benefits. Further studies using objective measures of physical activity are required to support these results

Can physical activity be used to maintain cognitive function in nursing home residents with dementia? A literature review

Background: Dementia is a noncommunicable disease with no effective prevention, treatment or cure. Evidence is emerging for the use of exercise to decelerate cognitive decline; however, few studies exist among nursing home residents and an optimum exercise protocol is yet to be determined. Objectives: To determine the effectiveness of physical activity in maintaining cognitive function in nursing home residents with dementia. Methods: Databases searched included CINAHL, MEDLINE complete, SPORTDiscus and ScienceDirect. Six relevant studies were identified and critically appraised using the Effective Public Health Practice Project Quality Assessment Tool. Results: All trials included different exercise programmes with various activity types and duration; all control interventions were social activities. Three studies demonstrated improved cognition in the intervention group, whilst one study observed a slower decline. Four studies found statistically significant cognitive decline in the control groups. Two studies observed no significant changes in either the intervention or control groups. Overall, there is moderate-to-moderate evidencestrong evidence that physical activity can effectively maintain cognitive function in nursing home residents with dementia. Conclusions: All interventions had a favourable effect on cognition. Results suggest that aerobic exercise of longer duration may be most effective for those with mild-to-moderate cognitive impairment; whilst multimodal programmes may be most effective for moderate-to-severe dementia. Combining an exercise programme with standard daily activities appears no more effective than exercise alone. Future research should aim to determine an optimum exercise protocol and whether the positive effects on cognition can be maintained long term with continued exercise

Validity of the new lifestyles NL-1000 accelerometer for measuring time spent in moderate-to-vigorous physical activity in school settings

Current interest in promoting physical activity in the school environment necessitates an inexpensive, accurate method of measuring physical activity in such settings. Additionally, it is recognized that physical activity must be of at least moderate intensity in order to yield substantial health benefits. The purpose of the study, therefore, was to determine the validity of the New Lifestyles NL-1000 (New Lifestyles, Inc., Lee's Summit, Missouri, USA) accelerometer for measuring moderate-to-vigorous physical activity in school settings, using the Actigraph GT1M (ActiGraph, Pensacola, Florida, USA) as the criterion. Data were collected during a cross-country run (n = 12), physical education (n = 18), and classroom-based physical activities (n = 42). Significant and meaningful intraclass correlations between methods were found, and NL-1000 estimates of moderate-to-vigorous physical activity were not meaningfully different from GT1M-estimated moderate- to-vigorous physical activity. The NL-1000 therefore shows promising validity evidence as an inexpensive, convenient method of measuring moderate-to-vigorous physical activity in school settings

Is fatness or fitness key for survival in older adults with intellectual disabilities?

Background: Overweight/obesity and poor physical fitness are two prevalent lifestyle-related problems in older adults with intellectual disabilities, which each require a different approach. To improve healthy ageing, we assessed whether fatness or fitness is more important for survival in older adults with intellectual disabilities. Methods: In the HA-ID study, we measured obesity and fitness of 874 older adults with intellectual disabilities (61.4 ± 7.8 years). Alsl-cause mortality was assessed over a 5-year follow-up period. Results: Fitness, but not obesity, was significantly related to survival (HR range of 0.17–0.22). People who were unfit were 3.58 (95% CI = 1.72–7.46) to 4.59 (95% CI = 1.97–10.68) times more likely to die within the follow-up period than people who were fit, regardless of obesity. Conclusion: This was the first study to show that being fit is more important for survival than fatness in older adults with intellectual disabilities. The emphasis should, therefore, shift from weight reduction to improving physical fitness

A Critical Appraisal of Guidelines for Antenatal Care: Components of Care and Priorities in Prenatal Education

There are a variety of published prenatal care (PNC) guidelines that claim a scientific basis for the information included. Four sets of PNC guidelines published between 2005 and 2009 were examined and critiqued. The recommendations for assessment procedures, laboratory testing, and education/counseling topics were analyzed within and between these guidelines. The PNC components were synthesized to provide an organized, comprehensive appendix that can guide providers of antepartum care. The appendix may be used to locate which guidelines addressed which topics to assist practitioners to identify evidence sources. The suggested timing for introducing and reinforcing specific topics is also presented in the appendix. Although education is often assumed to be a vital component of PNC, it was inconsistently included in the guidelines that were reviewed. Even when education was included, important detail was lacking. Addressing each woman\u27s needs as the first priority was suggested historically and remains relevant in current practice to systematically provide care while maintaining the woman as the central player. More attention to gaps in current research is important for the development of comprehensive prenatal guidelines that contribute effectively to the long‐term health and well‐being of women, families, and their communities

Early diagnosis of brain tumours using a novel spectroscopic liquid biopsy

Early diagnosis of brain tumours is challenging and a major unmet need. Patients with brain tumours most often present with non-specific symptoms more commonly associated with less serious diagnoses, making it difficult to determine which patients to priortitise for brain imaging. Delays in diagnosis affect timely access to treatment, with potential impacts on quality of life and survival. A test to help identify which patients with non-specific symptoms are most likely to have a brain tumour at an earlier stage would dramatically impact on patients by prioritising demand on diagnostic imaging facilities. This clinical feasibility study of brain tumour early diagnosis was aimed at determining the accuracy of our novel spectroscopic liquid biopsy test for the triage of patients with non-specific symptoms that might be indicative of a brain tumour, for brain imaging. Patients with a suspected brain tumour based on assesement of their symptoms in primary care can be referred for open access CT scanning. Blood samples were prospectively obtained from 385 of such patients, or patients with a new brain tumour diagnosis. Samples were analysed using our spectroscopic liquid biopsy test to predict presence of disease, blinded to the brain imaging findings. The results were compared to the patient’s index brain imaging delivered as per standard care. Our test predicted the presence of glioblastoma, the most common and aggressive brain tumour, with 91% sensitivity, and all brain tumours with 81% sensitivity, and 80% specificity. Negative predictive value was 95% and positive predictive value 45%. The reported levels of diagnostic accuracy presented here have the potential to improve current symptom-based referral guidelines, and streamline assessment and diagnosis of symptomatic patients with a suspected brain tumour

Supporting people with aphasia to ‘settle into a new way to be’: speech and language therapists’ views on providing psychosocial support

Background: People with aphasia are at risk of becoming depressed and isolated. On-line surveys have found that the majority of Speech and Language Therapists (SLTs) lack confidence in addressing the psychological needs of people with aphasia. Aims: To explore how SLTs conceptualise the scope of their role; barriers and facilitators to SLTs addressing psychosocial needs; and SLTs’ experiences of specialist training and support, and working with mental health professionals (MHPs). Methods and procedures: Focus groups conducted in stroke healthcare settings. Purposive sampling was used in selecting sites so as to capture a range of experiences. Results were analysed using Framework Analysis. Outcomes and Results: Twenty-three SLTs took part in six focus groups. Participants’ psychosocial work included counselling-type interactions, psychoeducation, working with families, facilitating peer support, and training other healthcare professionals. There was a lack of consensus on the scope of the SLT role. Many expressed a sense of conflict, both perceiving it as valuable to spend time addressing psychological well-being, while simultaneously feeling uneasy if they deviated from ‘direct SLT’ work. Barriers to addressing psychosocial wellbeing were: emotionally challenging nature of this work, particularly for those who felt unsupported; caseload and time pressures; attitude of senior managers and commissioners; difficulties measuring and documenting more ‘fluid’ psychosocial work; and the complexity of needs and backgrounds of some patients. Enabling factors were: specialist on-going support; peer support from colleagues; experience; support of management; and personal belief. Specialist training was valued. It changed how participants viewed the therapist-client relationship (more client-led); the assessment and goal setting process; and gave them more confidence to acknowledge client emotions. However, many felt that there was a need for on-going specialist advice, and to be able to see approaches modelled for this client group. In terms of mental health professionals (MHPs), a subset of stroke specialist clinical psychologists worked directly with people with marked aphasia and families, as well as supporting the multidisciplinary team to provide holistic care. However, a main theme was that participants perceived many MHPs did not consider people with aphasia as ‘appropriate candidates’ for psychological input. Conclusions and Implications: All participants cared about the emotional well-being of their clients; however, they identified a number of barriers to people with aphasia receiving appropriate psychological support. A cultural shift, whereby psychological care for people with aphasia is seen as valuable, feasible and necessary, delivered collaboratively by SLTs, MHPs and the wider team, may improve services