2,679 research outputs found
Changing professional practice and culture to get it right for every child: an evaluation of the development and early implementation phases of 'Getting it right for every child' in Highland: 2006-2009
Social capital elite, excluded participators, busy working parents and aging, participating less:types of community participators and their mental health
With the prevalence and costs of mental health problems increasing, safe, effective and economically viable prevention and treatment strategies are urgently needed. Community participation is protectively linked to mental health and is considered a vali
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To what extent do pupils perceive science to be inconsistent with religious faith? An exploratory survey of 13-14 year-old English pupils
Scientists hold a wide range of beliefs on matters of religion, although popular media coverage in the UK commonly suggests that atheism is a core commitment for scientists. Considering the relationship between religion and science is a recommended topic in the English National Curriculum for lower secondary pupils (11-14 year-olds), and it is expected that different perspectives will be considered. However it is well established that many pupils may have difficulty accessing sophisticated ideas about the nature of science, and previous research suggests some may identify science with scientism. To explore pupil impressions of the relationship between science and religion, 13-14 year old pupils were surveyed in one class from each of four English secondary schools, by asking them to rate a set of statements about the relationship between science and religion, and scientific and religious perspectives on the origins of the world, and of life on earth, on the value of prayer and on the status of miracles. The survey revealed diverse views on these issues, reflecting the wider society. However it was found that a considerable proportion of the pupils in the sample considered religious beliefs and scientific perspectives to be opposed. The basis and potential consequences of such views are considered, and the need for more attention to this area of student thinking is highlighted
Characterisation of cardiorespiratory responses to electrically stimulated cycle training in paraplegia
Functional, electrically stimulated (FES) cycle training can improve the cardiorespiratory
fitness of spinal cord injured (SCI) individuals, but the extent to which this can occur
following high volume FES cycle endurance training is not known. The effect of training
on aerobic endurance capacity, as determined by the appearance of respiratory gas exchange
thresholds, is also unknown. The oxygen cost (O2 cost) of this type of exercise is about 3.5
times higher than that of volitional cycling, but the source of this inefficiency, and of the
variation between subjects, has not yet been investigated. The electrical cost of FES cycling,
measured as the stimulation charge required per Watt of power produced (stim/Pt), has
neither been calculated nor investigated before. It is also not known whether a period of FES
cycling can alter the O2 cost or the stim/Pt of this unique form of exercise. Additionally, the
acute metabolic responses to prolonged, high intensity FES cycling after a 12-month period
of high-volume training have not yet been characterised for this subject group.
Accordingly, these parameters were investigated over the course of a 12-month homebased
FES cycle training programme (up to 5 x 60 min per week) in 9 male and 2 female
individuals with paraplegia. Outcomes were investigated using a novel, sensitive test bed that
accounted for both internal and external power production (Pt). The test protocol permitted
high resolution analyses of cycling power and metabolic thresholds, and a sensitive training
dose-response analysis, to be performed for the first time in FES cycling. Efficiency estimates
were calculated within a new theoretical framework that was developed for those with severe
disability, and the stim/Pt was determined using a novel measure designed for this study.
The current training programme resulted in significant improvements in cardiorespiratory
fitness and peak cycling power, but only over the first 6 months when training was progressive.
These improvements were positively related to the number of training hours completed during
this time. It is not known whether the plateau in training response that was found after this
time was due to a physiological limitation within the muscles, or to limitations in the current
stimulation strategy and of the training protocol used.
The efficiency of FES cycling was not significantly altered by any period of training.
However, the stim/Pt of cycling had reduced over the first 6 months, probably as a result
of a fibre hypertrophy within the stimulated motor units. The relationship that was found
between variables after this time suggest that differences in the efficiency of FES cycling
ii
between subjects and over time related primarily to the stim/Pt, which determined the
number of motor units recruited per unit of power produced, rather than to metabolic changes
within the muscle itself.
The aerobic gas exchange threshold (GET) was detected at an oxygen uptake (˙VO2)
equivalent to that normally elicited by very gentle volitional exercise, even after training. This
provided metabolic evidence of anaerobic fibre recruitment from the outset, as a consequence
of the non-physiological motor unit recruitment pattern normally found during FES.
The cardiorespiratory stress of training was found to be significantly higher than that
elicited by the incremental work rate tests, calling into question the validity of using
traditional, continuous incremental work rate tests for establishing the peak oxygen uptake
(˙VO2peak) of FES cycling. The respiratory exchange dynamics observed over a 60 min training
session were characterised and provide a unique insight into the remarkable aerobic and
anaerobic capacity of trained paralytic muscles.
For this particular highly motivated subject group, training for 60 min per day on more
than 4 days of the week was demonstrated to be feasible, but not able to be sustained. Further
work is therefore recommended to develop and to evaluate different stimulation patterns
and parameters, loading strategies and training protocols. The aim would be to determine
the optimal combination of training parameters that would maximise favourable training
responses within a more viable and sustainable lower volume, training programme for this
subject group.
In conclusion, the outcomes of this multi-centre study have demonstrated the clinical
significance of using otherwise redundant, paralytic leg muscles to perform functional,
regular physical exercise to improve cardiorespiratory and musculoskeletal health after SCI.
Additionally, the significant increases in cycling power and endurance that were achieved
opened up new mobility and recreational possibilities for this group of individuals. These
findings highlight the clinical and social relevance of regular FES cycle training, and the
importance of integrating FES cycling into the lives of those affected by SCI. The early and
judicious implementation of this form of exercise is strongly recommended for the maintenance
of a healthy body, wellbeing, and of an active lifestyle after SCI
Spinal direct current stimulation enhances vertical jump power in healthy adults
Transcutaneous spinal direct current stimulation (tsDCS) is a safe, non-invasive neuromodulation tool that can affect sensory, motor and pain spinal cord circuits and pathways. The polarity dependent neuroplastic effects are reported to persist after stimulation in a dose dependent manner. It is not known whether tsDCS neuromodulation can translate to any measurable change in functional motor power production post stimulation. In this study we investigate the effect of 15 min of anodal lumbosacral cord level tsDCS on vertical countermovement jump (VCJ) power production up to 3 hours after stimulation in healthy volunteers: the VCJ is a test of maximal lower limb power and involves a powerful eccentric countermovement. In tandem with this, we mapped concomitant changes in lower limb posterior root-muscle (PRM) reflexes over the same time course.We employed a double-blind, randomized, crossover sham-controlled design approved by our local ethics committee. 13 healthy individuals completed 5 maximal effort VCJs on a force platform before and 0, 20, 60 and 180 min after sham and active tsDCS (25 VCJs per session, at least 7 days apart). 6 of the subjects completed 2 further sham/active tsDCS session where lower limb PRM reflexes were induced before and up to 180 min after tsDCS using single pulse biphasic stimulation of the spine via the same electrode montage as in place for tsDCS.tsDCS induced a mean (95% CI) 15.4 (7.4—23.5)% difference in max (sham – 6.4%, active + 9%, p <0.001) and a 11.4 (5—17.8)% difference in ave (sham - 5%, active + 6.4%, p < 0.001) countermovement power, leading to an overall difference of 4.2 (2.1—6.4)% in max (sham -3.6%, active +0.6%, p < 0.001) and 3.7 (1.9—5.6)% difference in ave peak to peak VCJ power (sham -2.7%, active +1%, p < 0.001). These changes did not significantly differ between time point post tsDCS. We found that over both tsDCS conditions, changes in hamstring PRM reflexes were moderately correlated with changes in ave VCJ force (r = 0.60, p <0.001). Anodal tsDCS preserved and enhanced countermovement power production over three hours, whereas there was a significant fatigue effect after sham tsDCS. These changes appear to be due to changes in force potentiation mechanisms, demonstrated by excitability changes in reflex circuitry. We have shown for the first time that anodal tsDCS quickly, easily and painlessly counters the fatigue normally associated with repeated maximal power performance. tsDCS-induced fatigue resistance and an enhancement of motor power in the absence of physical training have important implications for rehabilitation after central nervous system injury
Social capital, health, and elderly driver status
Driving a car enables many people to engage in meaningful activities that, in turn, help develop and maintain personal social capital. Social capital, a combination of community participation and social cohesion, is important in maintaining well-being. This paper argues that social capital can provide a framework for investigating the general role of transportation and driving a car specifically to access activities that contribute to connectedness and well-being among older people. This paper proposes theoretically plausible and empirically testable hypotheses about the relationship between driver status, social capital, and well-being. A longitudinal study may provide a new way of understanding, and thus of addressing, the well-being challenges that occur when older people experience restrictions to, or loss of, their driver’s license
A model for incorporating a clinically-feasible exercise test in paraplegic annual reviews : a tool for stratified cardiopulmonary stress performance classification and monitoring
To identify and characterize an exercise test for use in routine spinal cord injury clinical review, and (ii) to describe levels of, and factors affecting, cardiopulmonary stress performance during exercise in the chronic paraplegic population in Scotland, UK. Cross-sectional study Queen Elizabeth National Spinal Injuries Unit (Glasgow, Scotland) 48 subjects with chronic paraplegia resulting from spinal cord injury at neurological levels T2-L2 Peak oxygen uptake, peak power output, gas exchange threshold and peak heart rate were determined from an incremental arm-cranking exercise test. Using a general linear model, the effects of gender, high (injury level above T6) versus low paraplegia, time since injury, body mass and age on peak oxygen uptake and peak power output were investigated. All 48 subjects completed the arm-cranking exercise test, which was shown to be practical for fitness screening in paraplegia. Men (n=38) had a peak oxygen uptake of 1.302 +/- 0.326 l.min-1 (mean +/- s.d.) and peak power output of 81.6 +/- 23.2W, which was significantly higher than for women (n=10), at 0.832 +/- 0.277 l.min-1 and 50.1 +/- 27.8 W, respectively. There was large intersubject variability in cardiopulmonary performance during arm-cranking exercise testing, but the overall mean for the Scottish population was lower than reference values from other countries. Arm-cranking exercise tests are feasible in the clinical environment. The motivation for their implementation is threefold: (i) to determine cardiopulmonary stress performance of individual paraplegic patients, (ii) to stratify patients into cardiovascular risk categories, and (iii) to monitor the effects of targeted exercise prescription
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