Evaluation of air-displacement plethysmography in children aged 5-7 years using a three-component model of body composition

The aim of the present study was to evaluate air-displacement plethysmography (ADP) in children aged 5-7 years. Body-composition measurements were obtained by ADP, H-2 dilution and anthropometry in twenty-eight children. Calculation of body volume by ADP was undertaken using adult and children's equations for predicting lung volume and surface area. Fat-free mass (FFM) was calculated using a three-component model. Measured FFM hydration was then compared with values from the reference child. Differences between measured and reference hydration were back-extrapolated, to calculate the error in ADP that would account for any disagreement. Propagation of error was used to distinguish the contributions of methodological precision and biological variability to total hydration variability. The use of children's equations influenced the results for lung volume but not surface area. The mean difference between measured and reference hydration was 0.6 (SD 1.7) % (P<0.10), equivalent to an error in body volume of 0.04 (So 0.20) litres (P<0.30), and in percentage fat of 0.4 (SD 1.9) (P<0.28). The limits of agreement in individuals could be attributed to methodological precision and biological variability in hydration. It is concluded that accuracy of ADP was high for the whole group, with a mean bias of <0.5% fat using the three-component model, and after taking into account biological variability in hydration, the limits of agreement were around 2 % fat in individuals. Paediatric rather than adult equations for lung volume estimation should be used

Deaf translators: What are they thinking?

The examination of work performed by Deaf translators in creating translations between written texts and signed languages is an emerging area of inquiry in Translation Studies. Deaf people have been performing ad hoc translations within their community for hundreds of years (Adam, Carty & Stone, 2011; Bartley & Stone, 2008). More recently, Deaf translators have begun to work as paid professionals, creating a new subfield of Translation Studies, one that, to date, is largely unexplored. Using qualitative data, this pilot study examines the thought processes of two Deaf individuals in the rendering of an academic text from written English into American Sign Language (ASL). Early analysis suggests four themes shared by the participants: 1) the importance of preparation; 2) the need for contextualization, 3) moving between literal versus free translation; and 4) consideration of the audience. This data shows that Deaf translators rely on linguistic knowledge and prior translation experience in creating and rendering their translations, a finding that in some respects aligns with studies on the processes of hearing translators. In addition to this, however, Deaf bilinguals appear to draw on a reservoir of extralinguistic knowledge (ELK) developed from their experiences as individuals living within the intersection of two languages, one of which employs a modality that is seldom used by majority populations. The aims of this exploratory study were to examine the thought processes that come into play in Deaf translators’ work and to consider new perspectives on Translation Studies from Deaf translators

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Weight centile crossing in infancy: correlations between successive months show evidence of growth feedback and an infant-child growth transition

Background: Early rapid weight gain is associated with later overweight, which implies that weight centile crossing tracks over time. Objective: Centile crossing is defined in terms of the change or deviation in weight z score during 1 mo, and the correlations between successive deviations are explored at different ages. Design: Two Cambridge (United Kingdom) growth cohorts were used: Widdowson (1094 infants born during 1959–1965) and the Cambridge Infant Growth Study (CIGS; 255 infants born during 1984–1987), each with weights measured monthly in the first year. Weights were converted to WHO age- and sex-adjusted z scores, deviations were calculated as the change in z score between adjacent measurement occasions, and the correlations between deviations were studied. Results: In both cohorts, the correlations between successive monthly deviations were positive in the first 6 mo and highest at ages 3–4 mo (r = 0.3, P < 0.0001), whereas after 6 mo they were negative and were lowest at ages 10–11 mo (r = –0.3, P < 0.0001), with the correlation decreasing linearly with age between these extremes. Thus, during the first 6 mo of age, infants crossing centiles in 1 mo tended to continue crossing centiles in the same direction the following month, whereas after 6 mo they tended to cross back again. This represents positive and negative feedback, respectively. At age 12 mo, the correlation was close to zero, which suggests an infant-child transition in growth. Conclusions: The results confirm that weight centile crossing tracks over time, with the correlations between successive periods that change with age suggesting a complex feedback mechanism underlying infant growth. This may throw light on the link between early rapid weight gain and later overweight. Clinically, the correlations indicate that when predicting future weight from current weight, recent centile crossing affects the prediction in an age-dependent manner

Hemiplegic Shoulder Pain Prevention: A Collaborative Approach with Nursing and Occupational Therapy in Acute Care

Introduction: Hemiplegic shoulder pain (HSP) is one of the most common and disabling complications of arm hemiplegia after stroke (Anwer & Alghadir, 2020), with a prevalence as high as 75% of strokes (Xie et al., 2021). HSP can develop as early as the second week (Praveen Raj et al., 2021), may continue several months after stroke in 65% of patients (Kumar, 2019), and is associated with reduced functional arm use (Kumar, 2019). Prevention is the ideal management strategy of HSP (K. Walsh, 2001). Implementing hemiplegic arm management techniques, such as positioning and handling, is key to preventing HSP. In the acute care setting, the nursing staff is the key provider for patients with arm hemiplegia after stroke. Therefore, the nursing staff must have knowledge and skill to prevent HSP through positioning and handling. Objectives: To evaluate the effectiveness of collaboration between nursing and occupational therapy to improve adherence to positioning and handling techniques that can prevent HSP in an acute care hospital using knowledge translation (KT) strategies Methods: This project was a 10-week quality improvement project using KT principles in 25-bed neurology unit located at Strong Memorial Hospital, a comprehensive stroke center of the University of Rochester Medical Center in Rochester, NY. Participants included 34 dayshift nursing staff assigned to the neurology unit. Observations in week one established the baseline use of positioning and handling techniques. The following week, the nursing staff received mini-training in positioning and handling techniques during morning and afternoon routine patient care across three weeks. Post-training, audit and feedback (A&F) were implemented for six weeks to include raters\u27 observations of the nursing staff’s adherence to the techniques during routine care and the nursing staff’s identification of barriers and facilitators to technique implementation through informal surveys. Based on weekly audits and surveys, the occupational therapist and nurse educator provided feedback and tailored interventions to support adherence for the following week. Additional KT strategies implemented throughout the project included knowledge champions, infographics, screensavers, wristbands, and positioning and handling orders in the patients’ charts. Results: Baseline observations confirmed that positioning and handling techniques known to prevent HSP were minimally implemented into routine patient care. Post-training, 207 observations were performed over six weeks. Observations at the program’s end demonstrated increased adherence to positioning techniques from 18% at baseline to 71% and handling techniques from 50% at baseline to 91% among the nursing staff. Conclusion: This QI project effectively increased the nursing staff’s adherence to best practices in positioning and handling techniques for patients with arm hemiplegia after stroke. The collaborative approach and various KT strategies were vital to this program’s success. Reference Anwer, S., & Alghadir, A. (2020). Incidence, prevalence, and risk factors of hemiplegic shoulder pain: A systematic review. International Journal of Environmental Research and Public Health, 17(14). https://doi.org/10.3390/ijerph17144962 American Occupational Therapy Association. (2016). Scholarship in occupational therapy. American Journal of Occupational Therapy, 70(7012410080). American Occupational Therapy Association, (2021). Vision 2025 retrieved on January 28, 2022 from https://www.aota.org/about/mission-vision. Donati, D., Miccoli, G. A., Cianfrocca, C., Di Stasio, E., De Marinis, M. G., & Tartaglini, D. (2020). Effectiveness of implementing link nurses and audits and feedback to improve nurses’ compliance with standard precautions: A cluster randomized controlled trial. American Journal of Infection Control, 48(10), 1204-1210 Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: time for a map?. Journal of continuing education in the health professions, 26(1), 13-24. Jamtvedt, G., Flottorp, S., & Ivers, N. (2021). Audit and feedback as a quality strategy. Improving healthcare quality in Europe, 265. Jolliffe, L., Morarty, J., Hoffmann, T., Crotty, M., Hunter, P., Cameron, I. D., Li, X., & Lannin, N. A. (2019). Using audit and feedback to increase clinician adherence to clinical practice guidelines in brain injury rehabilitation: A before and after study. Plos One, 14(3), e0213525. https://doi.org/10.1371/journal.pone.0213525 Kumar, P. (2019). Hemiplegic shoulder pain in people with stroke: present and the future. Pain Management, 9(2), 107–110. https://doi.org/10.2217/pmt-2018-0075 Li, Z. & Alexander, S. A. (2015) Evidence in the management of poststroke hemiplegic shoulder pain: A review. Journal of Neuroscience Nursing, (47)1, 10-19. doi: 10.1097/JNN.0000000000000109 Murie-Fernández, M., Carmona Iragui, M., Gnanakumar, V., Meyer, M., Foley, N., & Teasell, R. (2012). [Painful hemiplegic shoulder in stroke patients: causes and management]. Neurologia (Barcelona, Spain), 27(4), 234–244. https://doi.org/10.1016/j.nrl.2011.02.010 Praveen Raj, J. D., Dsouza, S. A., Sitaram, A., & Umakanth, S. (2021). Effectiveness of caregiver education for prevention of shoulder pain in acute stroke survivors: A randomised controlled trial. Disability, CBR & Inclusive Development, 32(1), 66. https://doi.org/10.47985/dcidj.378 Tinetti, M. E., Baker, D. I., King, M., Gottschalk, M., Murphy, T. E., Acampora, D., ... & Allore, H. G. (2008). Effect of dissemination of evidence in reducing injuries from falls. New England Journal of Medicine, 359(3), 252-261. Walsh, K. (2001). Management of shoulder pain in patients with stroke. Postgraduate Medical Journal, 77(912), 645–649. https://doi.org/10.1136/pmj.77.912.645 Walsh, M., Ashford, S., Rose, H., Alfonso, E., Steed, A., & Turner-Stokes, L. (2022). Stratified management of hemiplegic shoulder pain using an integrated care pathway: an 18-year clinical cohort analysis. Disability and Rehabilitation, 44(20), 5909–5918. https://doi.org/10.1080/09638288.2021.1951851 Whilatch, J. & Hall, V., (2015). Defining Scholarship for Today’s Nurse Educator. Retrieved April 10, 2022 from https://sigma.nursingrepository.org/bitstream/handle/10755/601835/1_Whtilatch_J_p71064_1.pdf?sequence=1&isAllowed=y Winegar, R., Lach, H., Lorenz, R., & Henderson, D. (2017). Hemiparetic positioning of patients with hemiplegia. Journal of Doctoral Nursing Practice, 10(2), 129–134. https://doi.org/10.1891/2380-9418.10.2.129 Xie, H.-M., Guo, T.-T., Sun, X., Ge, H.-X., Chen, X.-D., Zhao, K.-J., & Zhang, L.-N. (2021). Effectiveness of Botulinum Toxin A in Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-analysis. Archives of Physical Medicine and Rehabilitation, 102(9), 1775–1787. https://doi.org/10.1016/j.apmr.2020.12.010 Synopsis: Shoulder pain in a weak arm after stroke is common and disabling. Using methods to prevent shoulder pain after a stroke is necessary. This quality improvement project evaluated the benefits of occupational therapy and the nursing staff working to improve positioning and handling methods to prevent shoulder pain for patients after a stroke. Three weeks of education was provided to the nursing staff on positioning and handling methods with reinforcement throughout the project. After education, the nursing staff’s use of the methods were watched for six weeks. The nursing staff’s use of the methods improved by the project’s end. Acknowledgments: Dr. Amy Carroll, OTD, OTR/L; Shannon J Smith, MS, RN; Jordan Fluellen, RN; Tracy Hardes, PTA, CSRS; Jayne Knowlton, OTD, OTR/L; Kathleen Stoklosa, OTD, OTR/L; University of Rochester Medical Center, neurology nurse management, neurology nursing staf

Body composition reference charts for UK infants and children aged 6 weeks to 5 years based on measurement of total body water by isotope dilution

BACKGROUND: Until recently, pediatric body composition reference data were very limited, hindering interpretation of measurements. In the last decade, such data emerged for several techniques for children ≥ 5 years, but equivalent data for younger age groups remain lacking, due to their poor compliance with most techniques. // OBJECTIVES: To provide reference data for use in clinical practice and research from 6 weeks to 5 years, that are based on measurements of total body water (TBW) by isotope dilution. // DESIGN: The data on anthropometry and TBW were available from studies of 463 infants and children aged 6 weeks to 7 years, conducted between 1988 and 2010. Both breast-fed and formula-fed infants were included. TBW was measured by 2H- or 18O-labeled water, and converted to fat-free mass (FFM) using published hydration coefficients. Reference charts and SD scores (SDS) were constructed for FFM, fat mass (FM), FFM index and FM index for each sex, using the lambda-mu-sigma method. // RESULTS: Both sexes were significantly heavier and longer than UK 1990 reference data (p < 0.01), but did not differ in body mass index SDS. Breast-fed infants were longer than formula-fed infants but did not differ in body composition. // CONCLUSIONS: These reference data will enhance the ability of clinicians to assess and monitor body composition and FFM/FM accretion in clinical practice in younger age groups. Total body water can be measured in most patients, though abnormalities of hydration must be addressed. However, the centiles do not overlap exactly with those published for older age groups, limiting comparability between younger and older children

The Galaxy Structure-Redshift Relationship

There exists a gradual, but persistent, evolutionary effect in the galaxy population such that galaxy structure and morphology change with redshift. This galaxy structure-redshift relationship is such that an increasingly large fraction of all bright and massive galaxies at redshifts 2 < z < 3 are morphologically peculiar at wavelengths from rest-frame ultraviolet to rest-frame optical. There are however examples of morphologically selected spirals and ellipticals at all redshifts up to z ~ 3. At lower redshift, the bright galaxy population smoothly transforms into normal ellipticals and spirals. The rate of this transformation strongly depends on redshift, with the swiftest evolution occurring between 1 < z < 2. This review characterizes the galaxy structure-redshift relationship, discusses its various physical causes, and how these are revealing the mechanisms responsible for galaxy formation.Comment: 20 pages, 8 figures. Invited Review to appear in "Penetrating Bars Through Masks of Cosmic Dust: The Hubble Tuning Fork Strikes A New Note", ed. D. Block et a