371 research outputs found

    Mii-vitaliSe: a pilot randomised controlled trial of a home gaming system (Nintendo Wii) to increase activity levels, vitality and well-being in people with multiple sclerosis.

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    OBJECTIVES: While the health and well-being benefits of physical activity are recognised, people with multiple sclerosis (MS) often face greater barriers than the general population. The Nintendo Wii potentially offers a fun, convenient way of overcoming some of these. The aim was to test the feasibility of conducting a definitive trial of the effectiveness and cost-effectiveness of Mii-vitaliSe; a home-based, physiotherapist-supported Nintendo Wii intervention. DESIGN: A single-centre wait-list randomised controlled study. SETTING: MS service in secondary care. PARTICIPANTS: Ambulatory, relatively inactive people with clinically confirmed MS. INTERVENTION: Thirty participants were randomised to receive Mii-vitaliSe either immediately (for 12 months) or after a 6-month wait (for 6 months). Mii-vitaliSe consisted of two supervised Nintendo Wii familiarisation sessions in the hospital followed by home use (Wii Sports, Sports Resort and Fit Plus software) with physiotherapist support and personalised resources. OUTCOMES: Included self-reported physical activity levels, quality of life, mood, self-efficacy, fatigue and assessments of balance, gait, mobility and hand dexterity at baseline, 6 and 12 months. Interviews (n=25) explored participants' experiences and, at study end, the two Mii-vitaliSe facilitators' experiences of intervention delivery (main qualitative findings reported separately). RESULTS: Mean (SD) age was 49.3 (8.7) years, 90% female, with 47% diagnosed with MS <6 years ago and 60% new to active gaming. The recruitment rate was 31% (95% CI 20% to 44%). Outcome data were available for 29 (97%) at 6 months and 28 (93%) at 12 months. No serious adverse events were reported during the study. Qualitative data indicated that Mii-vitaliSe was well-received. Mean Wii use across both groups over the initial 6-month intervention period was twice a week for 27 min/day. Mean cost of delivering Mii-vitaliSe was £684 per person. DISCUSSION: Mii-vitaliSe appears acceptable and a future trial feasible and warranted. These findings will inform its design. TRIAL REGISTRATION: ISRCTN49286846

    Genetic and morphological divergence between Littorina fabalis ecotypes in Northern Europe

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    Low dispersal marine intertidal species facing strong divergent selective pressures associated with steep environmental gradients have a great potential to inform us about local adaptation and reproductive isolation. Among these, gastropods of the genus Littorina offer a unique system to study parallel phenotypic divergence resulting from adaptation to different habitats related with wave exposure. In this study, we focused on two Littorina fabalis ecotypes from Northern European shores and compared patterns of habitat-related phenotypic and genetic divergence across three different geographic levels (local, regional and global). Geometric morphometric analyses revealed that individuals from habitats moderately exposed to waves usually present a larger shell size with a wider aperture than those from sheltered habitats. The phenotypic clustering of L. fabalis by habitat across most locations (mainly in terms of shell size) support an important role of ecology in morphological divergence. A genome scan based on amplified fragment length polymorphisms (AFLPs) revealed a heterogeneous pattern of differentiation across the genome between populations from the two different habitats, suggesting ecotype divergence in the presence of gene flow. The contrasting patterns of genetic structure between nonoutlier and outlier loci, and the decreased sharing of outlier loci with geographic distance among locations are compatible with parallel evolution of phenotypic divergence, with an important contribution of gene flow and/or ancestral variation. In the future, model-based inference studies based on sequence data across the entire genome will help unravelling these evolutionary hypotheses, improving our knowledge about adaptation and its influence on diversification within the marine realm.Peer reviewe

    SCHISTOX: An individual based model for the epidemiology and control of schistosomiasis.

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    A stochastic individual based model, SCHISTOX, has been developed for the study of schistosome transmission dynamics and the impact of control by mass drug administration. More novel aspects that can be investigated include individual level adherence and access to treatment, multiple communities, human sex population dynamics, and implementation of a potential vaccine. Many of the model parameters have been estimated within previous studies and have been shown to vary between communities, such as the age-specific contact rates governing the age profiles of infection. However, uncertainty remains as there are wide ranges for certain parameter values and a few remain relatively unknown. We analyse the model dynamics by parameterizing it with published parameter values. We also discuss the development of SCHISTOX in the form of a publicly available open-source GitHub repository. The next key development stage involves validating the model by calibrating to epidemiological data

    Commentary on the use of the reproduction number R during the COVID-19 pandemic

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    Since the beginning of the COVID-19 pandemic, the reproduction number R has become a popular epidemiological metric used to communicate the state of the epidemic. At its most basic, R is defined as the average number of secondary infections caused by one primary infected individual. R seems convenient, because the epidemic is expanding if R>1 and contracting if R<1. The magnitude of R indicates by how much transmission needs to be reduced to control the epidemic. Using R in a naïve way can cause new problems. The reasons for this are threefold: (1) There is not just one definition of R but many, and the precise definition of R affects both its estimated value and how it should be interpreted. (2) Even with a particular clearly defined R, there may be different statistical methods used to estimate its value, and the choice of method will affect the estimate. (3) The availability and type of data used to estimate R vary, and it is not always clear what data should be included in the estimation. In this review, we discuss when R is useful, when it may be of use but needs to be interpreted with care, and when it may be an inappropriate indicator of the progress of the epidemic. We also argue that careful definition of R, and the data and methods used to estimate it, can make R a more useful metric for future management of the epidemic

    Responding to pupil led tangential thinking: a case study of teaching romantic poetry in a post-16 setting

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    This paper considers alternative ways of teaching Romantic poetry to post-sixteen English Literature pupils in England. It explores how practitioners can value tangents developed by pupils’ independent thinking when pupils are given the freedom to develop their own ideas. It reflects on a lesson planned to respond to a tangent developed by the class in a previous session; that William Blake’s “The Tyger”, to a contemporary reader, explores the 21st century preoccupation of climate change. The lesson outlined in this report built upon these ideas further, valuing the pupils’ tangential thinking. Approaches like these are particularly important now as the performativity agenda in schools, promoted by league tables as a measure of effectiveness, can result in some schools teaching to the test, at the exclusion of encouraging personal and creative responses to texts

    Fertility, Living Arrangements, Care and Mobility

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    There are four main interconnecting themes around which the contributions in this book are based. This introductory chapter aims to establish the broad context for the chapters that follow by discussing each of the themes. It does so by setting these themes within the overarching demographic challenge of the twenty-first century – demographic ageing. Each chapter is introduced in the context of the specific theme to which it primarily relates and there is a summary of the data sets used by the contributors to illustrate the wide range of cross-sectional and longitudinal data analysed

    Return mobilities of highly skilled young people to a post-conflict region: the case of Kurdish-British to Kurdistan – Iraq

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    Building upon insights from recent studies on the ‘return mobilities’ of children of migrants to their parents’ country of origin, this paper focuses on the motives of highly skilled young people from the UK who migrate to their parental post-conflict region (Kurdistan-Iraq), an area that has experienced long-term conflict and profound economic and political instability. The existing studies on children of migrants’ return mobilities place more emphasis on cultural and economic considerations while paying little attention to the associated ideological and political elements. Based on interviews concerning 32 highly skilled young British-Kurdish people’s migration to Kurdistan-Iraq, this paper argues that the transnational mobilities of the 1.5 generation and second generation of refugee-diasporas are more driven by the collective trauma of their parents’ displacement, their feeling of expulsion and intergenerational articulation with an imagined homeland, than they are by economic considerations and/or nostalgia. The Kurdish political aspiration to develop Kurdish institutions and a national economy for a potential statehood in Northern Iraq has also created hope among young Kurdish people and influenced their motivations to ‘return’. In this context, this paper focuses on the political, ideological and emotional dimensions of return mobilities and draws attention to return mobilities among a new generation of refugees to their parental post-conflict homeland

    Naturally occurring variation in tadpole morphology and performance linked to predator regime

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    Divergent natural selection drives a considerable amount of the phenotypic and genetic variation observed in natural populations. For example, variation in the predator community can generate conflicting selection on behavioral, life-history, morphological, and performance traits. Differences in predator regime can subsequently increase phenotypic and genetic variations in the population and result in the evolution of reproductive barriers (ecological speciation) or phenotypic plasticity. We evaluated morphology and swimming performance in field collected Bronze Frog larvae (Lithobates clamitans) in ponds dominated by predatory fish and those dominated by invertebrate predators. Based on previous experimental findings, we hypothesized that tadpoles from fish-dominated ponds would have small bodies, long tails, and large tail muscles and that these features would facilitate fast-start speed. We also expected to see increased tail fin depth (i.e., the tail-lure morphology) in tadpoles from invertebrate-dominated ponds. Our results support our expectations with respect to morphology in affecting swimming performance of tadpoles in fish-dominated ponds. Furthermore, it is likely that divergent natural selection is playing a role in the diversification on morphology and locomotor performance in this system
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