Oxygen Consumption of Firefighters During Occupationally Specific Tasks

This study evaluated the physiological costs of specific occupational firefighter (FF) tasks. Subjects were 30 active FF\u27s (\u3e20 hours/month on duty) with a mean age of 34+8.69 years. Measurements including oxygen consumption and heart rate (HR) were recorded while a subject performed occupational tasks designed to simulate the challenges of firefighting. These tasks are typically components of a mandatory, pre-employment physical fitness assessment. Each subject completed two days of testing. Day one included a VO2max test on a treadmill. On day two, HR and oxygen consumption were measured during two FF tasks including a stair climb (SC) and victim rescue (VR). Participants wore a 40-pound weighted vest during the SC and VR tests and National Fire Protection Agency (NFPA) approved jacket. pants. and boots. Maximum oxygen consumption was 41.79±7.82 ml kg-1 min-1, which ranged from 29.50-59.30 ml kg-1 min-1. During the SC and VR tasks, subjects worked at 77.13% and 75.40% of VO2max. respectively. Likewise, HRmax was 190.4±2.01 bpm. and varied from 167-207 bpm. Relative HR during SC and VR was 66.36% and 51.50%, respectively. Based on these data, the minimum recommended VO2max for FF to perform these occupational tasks at or below 75% VO2max was 37.16 ml kg-1 min-1. As such, 36.7% of our subjects failed to attain this VO2max. In the best interest of firefighters and public safety. we recommend biannual evaluation to determine VO2max of a FF. and for that to serve as a basis for a safe and effective exercise program. Physical performance testing limited to the onset of hire is not in the best interest of the FF. Both performance testing and regular exercise participation should be a regular and integral part of the FF\u27s job

Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review

Objective: Attention control comparisons in trials of stroke rehabilitation require care to minimize the risk of comparison choice bias. We compared the similarities and differences in SLT and social support control interventions for people with aphasia. Data sources: Trial data from the 2016 Cochrane systematic review of SLT for aphasia after stroke. Methods: Direct and indirect comparisons between SLT, social support and no therapy controls. We double-data extracted intervention details using the template for intervention description and replication. Standardized mean differences and risk ratios (95% confidence intervals (CIs)) were calculated. Results: Seven trials compared SLT with social support (n  =  447). Interventions were matched in format, frequency, intensity, duration and dose. Procedures and materials were often shared across interventions. Social support providers received specialist training and support. Targeted language rehabilitation was only described in therapy interventions. Higher drop-out (P  =  0.005, odds ratio (OR) 0.51, 95% CI 0.32–0.81) and non-adherence to social support interventions (P  <  0.00001, OR 0.18, 95% CI 0.09–0.37) indicated an imbalance in completion rates increasing the risk of control comparison bias. Conclusion: Distinctions between social support and therapy interventions were eroded. Theoretically based language rehabilitation was the remaining difference in therapy interventions. Social support is an important adjunct to formal language rehabilitation. Therapists should continue to enable those close to the person with aphasia to provide tailored communication support, functional language stimulation and opportunities to apply rehabilitation gains. Systematic group differences in completion rates is a design-related risk of bias in outcomes observed

Investing When It Counts: Reviewing the Evidence and Charting a Course of Research and Action for Very Young Adolescents

Since 2006, there has been a burgeoning interest in the very young adolescent population and an ever-expanding array of programs aimed at addressing their social, health, and development needs. This report builds on the momentum generated from recent research and program efforts, and from the greater data available in the past decade. The report is intended to be helpful to anyone who plans, manages, implements, monitors, evaluates, or funds research or programs that involve young adolescent girls and boys. The report outlines several key areas that would benefit from more experimentation and new research. Central to this is the creation of community platforms/meeting places—places for skill building and safe engagement, especially for girls whose social space is already confined and in many cases shrinking

Speech and language therapy for aphasia following stroke

Our review provides some evidence of the effectiveness of SLT (speech and language therapy) for people with aphasia following stroke in terms of improved functional communication, receptive and expressive language. However, some trials were poorly reported. The potential benefits of intensive SLT over conventional SLT were confounded by a significantly higher dropout from intensive SLT. More participants also withdrew from social support than SLT interventions. There was insufficient evidence to draw any conclusion regarding the effectiveness of any one specific SLT approach over another

Distribution of the birds of the Philippines: biogeography and conservation priorities

The Philippine islands hold a concentration of species diversity and endemism of global importance, yet few studies have analyzed biogeographic patterns or attempted to prioritize areas for conservation within the archipelago. We analyzed distributions of 386 species on 28 Philippine islands and island groups, documenting intense concentration of species richness, especially of endemic species, on the two largest islands, Mindanao and Luzon. Factors identified as influencing species richness included island area, maximum elevation, and Pleistocene patterns of connection and isolation. Reserve systems were developed based on heuristic complementarity algorithms, and compared with the existing Integrated Protected Areas (IPAS) system in the country, showing that IPAS is an impressive first step towards protecting avian diversity in the country. Addition of presently proposed reserves on Palawan and Mindoro would make IPAS a near-optimal reserve design, at least at the level of island representation. Important challenges remain, however, with regard to design of reserve systems within islands to represent complete island avifaunas

Speech and language therapy for aphasia following stroke

Background  Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia.  Objectives  To assess the effects of speech and language therapy (SLT) for aphasia following stroke.  Search methods  We searched the Cochrane Stroke Group Trials Register (last searched 9 September 2015), CENTRAL (2015, Issue 5) and other Cochrane Library Databases (CDSR, DARE, HTA, to 22 September 2015), MEDLINE (1946 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), AMED (1985 to September 2015), LLBA (1973 to September 2015), and SpeechBITE (2008 to September 2015). We also searched major trials registers for ongoing trials including ClinicalTrials.gov (to 21 September 2015), the Stroke Trials Registry (to 21 September 2015), Current Controlled Trials (to 22 September 2015), and WHO ICTRP (to 22 September 2015). In an effort to identify further published, unpublished, and ongoing trials we also handsearched theInternational Journal of Language and Communication Disorders(1969 to 2005) and reference lists of relevant articles, and we contacted academic institutions and other researchers. There were no language restrictions.  Selection criteria  Randomised controlled trials (RCTs) comparing SLT (a formal intervention that aims to improve language and communication abilities, activity and participation) versus no SLT; social support or stimulation (an intervention that provides social support and communication stimulation but does not include targeted therapeutic interventions); or another SLT intervention (differing in duration, intensity, frequency, intervention methodology or theoretical approach).  Data collection and analysis  We independently extracted the data and assessed the quality of included trials. We sought missing data from investigators.  Main results  We included 57 RCTs (74 randomised comparisons) involving 3002 participants in this review (some appearing in more than one comparison). Twenty-seven randomised comparisons (1620 participants) assessed SLT versus no SLT; SLT resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language, but (based on smaller numbers) benefits were not evident at follow-up. Nine randomised comparisons (447 participants) assessed SLT with social support and stimulation; meta-analyses found no evidence of a difference in functional communication, but more participants withdrew from social support interventions than SLT. Thirty-eight randomised comparisons (1242 participants) assessed two approaches to SLT. Functional communication was significantly better in people with aphasia that received therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time. The benefits of a high intensity or a high dose of SLT were confounded by a significantly higher dropout rate in these intervention groups. Generally, trials randomised small numbers of participants across a range of characteristics (age, time since stroke, and severity profiles), interventions, and outcomes.  Authors' conclusions  Our review provides evidence of the effectiveness of SLT for people with aphasia following stroke in terms of improved functional communication, reading, writing, and expressive language compared with no therapy. There is some indication that therapy at high intensity, high dose or over a longer period may be beneficial. HIgh-intensity and high dose interventions may not be acceptable to all.REF Eligible with Permitted Exceptio

A high-throughput screening RT-qPCR assay for quantifying surrogate markers of immunity from PBMCs

Immunoassays that quantitate cytokines and other surrogate markers of immunity from peripheral blood mononuclear cells (PBMCs), such as flow cytometry or Enzyme-Linked Immunosorbent Spot (ELIspot), allow highly sensitive measurements of immune effector function. However, those assays consume relatively high numbers of cells and expensive reagents, precluding comprehensive analyses and high-throughput screening (HTS). To address this issue, we developed a sensitive and specific reverse transcription-quantitative PCR (RT-qPCR)-based HTS assay, specifically designed to quantify surrogate markers of immunity from very low numbers of PBMCs. We systematically evaluated the volumes and concentrations of critical reagents within the RT-qPCR protocol, miniaturizing the assay and ultimately reducing the cost by almost 90% compared to current standard practice. We assessed the suitability of this cost-optimized RT-qPCR protocol as an HTS tool and determined the assay exceeds HTS uniformity and signal variance testing standards. Furthermore, we demonstrate this technique can effectively delineate a hierarchy of responses from as little as 50,000 PBMCs stimulated with CD4+ or CD8+ T cell peptide epitopes. Finally, we establish that this HTS-optimized protocol has single-cell analytical sensitivity and a diagnostic sensitivity equivalent to detecting 1:10,000 responding cells (i.e., 100 Spot Forming Cells/106 PBMCs by ELIspot) with over 90% accuracy. We anticipate this assay will have widespread applicability in preclinical and clinical studies, especially when samples are limited, and cost is an important consideration