E-survey of current international physiotherapy practice for children with ataxia following surgical resection of posterior fossa tumour.

ObjectiveTo determine current international practice regarding physiotherapy input for children with ataxia following surgery for posterior fossa tumour. Design: An e-survey covering the following domains: participant demographics, treatment/ intervention, virtual training, intensity/timing of treatment, and aims and outcomes of physiotherapy management.ParticipantsPhysiotherapists involved in the management of children with ataxia following surgical resection of posterior fossa tumour. Participants were contacted via 6 key groups; Paediatric Oncology Physiotherapy Network (POPs), Association of Paediatric Chartered Physiotherapists (APCP), European Paediatric Neurology Society (EPNS), International Society of Paediatric Oncology (SIOP)-Europe Brain Tumour Group, Posterior Fossa Society (PFS), and Pediatric Oncology Special Interest Group (SIG) (American Physical Therapy Association).ResultsA total of 96 physiotherapists participated: UK (n =53), rest of Europe (n = 23), USA/ Canada (n = 10), and Australia/NZ (n = 10). The most common physiotherapy interventions used were balance exercises, gait re-education and proximal control activities. The most frequently used adjuncts to treatment were mobility aids and orthotics. Challenges reported regarding physiotherapy treatment were: reduced availability of physiotherapy input following discharge from the acute setting, lack of evidence, impact of adjuvant oncology treatment, and psychosocial impact.ConclusionThis e-survey provides an initial scoping review of international physiotherapy practice in this area. It establishes a foundation for future research on improving rehabilitation of ataxia in this population

La co-conception pour engager collègues et étudiants dans les pédagogies actives en physique

Affiche présentée dans le cadre du colloque de l'ARC «Favoriser l’accès et le partage par la création d’un observatoire» lors du 86e Congrès de l'Acfas à l' Université du Québec à Chicoutimi (UQAC), les 7 et 8 mai 2018.La pédagogie active (PA) améliore nettement l’apprentissage des élèves. Cependant, plusieurs professeurs ont de la difficulté à la mettre en oeuvre efficacement. Sans persévérance ou conseils, ils se découragent et reviennent à un style d'enseignement plus traditionnel. Nous présentons comment la co-conception d'activités a permis l’engagement d’un plus grand nombre de professeurs dans la mise en oeuvre de la PA. La co-conception d'activités fait référence à la collaboration entre chercheurs en pédagogie et professeurs dans la conception de nouvelles PA. L’objectif est de maximiser l'engagement et l'apprentissage des étudiants, tout en considérant l’importance de la préparation et de la réflexion à l'apprentissage. Des activités en plusieurs étapes (avant, pendant et après le cours) ont été développées. Elles utilisent les plateformes numériques, l'enseignement par les pairs et l’approche de classe inversée. Nous avons observé 9 professeurs de physique (15 groupes d’environ 25-30 étudiants) à plusieurs reprises. Les données qualitatives démontrent l’adaptabilité des activités : les professeurs enseignant dans différentes salles de cours (traditionnelles ou interactives) ainsi que ceux qui souhaitent utiliser moins de technologies numériques peuvent tout autant accomplir les activités. Nous comparons les différentes mises en oeuvre utilisées par les professeurs lors de l’exécution de ces nouvelles activités et nous examinons l'évolution des réalisations étudiantes

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Date of Award2002 Department History First Advisor Marcia G. Synnot

An exploration of the lived experience of progressive cerebellar Ataxia: An interpretative phenomenological analysis

This thesis was submitted for the degree of Doctor of Philosophy and was awarded by Brunel UniversityBackground and Purpose: Progressive cerebellar ataxia is a rare neurological condition characterised by uncoordinated movement, and impaired speech articulation. Rehabilitation and physiotherapy in particular, form the cornerstone of healthcare intervention. Little qualitative research has been undertaken to understand the subjective experience of this complex condition. This study explored the experience of progressive cerebellar ataxia, physiotherapy and physiotherapy services from the perspective of people living with this condition. Method: Interpretative Phenomenological Analysis underpinned this inductive qualitative enquiry. Twelve people with a progressive cerebellar ataxia participated in semi-structured interviews. All participants had some experience of physiotherapy. Interviews were transcribed. A case by case idiographic analysis was undertaken followed by a cross case analysis. Findings: Five super-ordinate themes were identified. ‘The embodied experience of progressive cerebellar ataxia’ emphasised the foregrounding of the body, and the disruption of the skilful interaction between body and world. ‘Identity, stigma and disrupted embodiment in public spaces and places’ encapsulated how participants made sense of actual and perceived stigma and discrimination. ‘Lifeworld meets biomedicine: a complex juxtaposition’ described participants’ problematic relationships with healthcare practitioners and their disease-centric world. ‘Wresting control in the face of uncertain and changing forces’ portrayed participants’ attempts to understand and reinterpret their condition on their own terms. ‘Exercise: a multifaceted contributor to managing life with ataxia’ captured the meaning of exercise and physical activity. One over-arching theme, ‘Retaining a homelike way of being-in-the-world’, cautiously indicated that whilst participants described ‘unhomelike’ lifeworlds (uncomfortable and disturbing); they simultaneously held onto, and sometimes realised, the possibility of ‘homecoming’, for example through the generation of new modes of belonging. Conclusion: This study provided a detailed, phenomenological account of the lived experience of progressive cerebellar ataxia. New insights were developed that have the capacity to inform not only physiotherapy practice but also other healthcare disciplines. New avenues for future research were also identified.Ataxia U

Identification of SNPs in the Coding Region of Human mtDNA

Two novel single nucleotide polymorphisms (SNPs) were discovered within the coding region of the NADH dehydrogenase subunit 2 gene of mitochondrial DNA (mtDNA). mtDNA is of particular importance in forensic analysis as well as in the study of the origin and dispersal of humans. Two segments of the coding region of human mtDNA, as well as the hyper-variable region 2 (HV 2) were selected and sequenced in order to determine if any previously unknown SNPs were present in our test subjects. Target regions were designed to include known SNPs; appropriate primers were developed using the OLIGO 6 Primer Analysis Software. The DNA was isolated using the QIAGEN® Generation Capture Column DNA Extraction kit and target regions were amplified via polymerase chain reaction (PCR). Once the fragment sizes were verified using acrylamide gel electrophoresis, the template DNA was prepared for sequencing by PCR using forward primers and IRDyeTM labeled dideoxy-terminators. Sequencing PCR products were then purified to remove excess primers and nucleotides and sequenced with the LICOR NEN model 4300 slab-gel DNA sequencer. The SNP analyses developed in this research have been implemented into the Minnesota State University, Mankato biochemistry laboratory curriculum. The two novel SNPs identified were: T644G and T4733G inside the NADH dehydrogenase subunit 2 gene. Each of these occurred in only one of our test subjects. No novel SNPs were found in the HV 2 region. However, sequencing was successful for only one of DNA test samples. Seven previously known SNPs were also found: G3010A and C3116T contained in the 16S rRNA coding region; T4216C contained in the NADH dehydrogenase 1 subunit gene; C4312T contained in the isoleucine tRNA gene; G4491A, T4586C, and T4688C contained in the NADH dehydrogenase 2 subunit gene

Sensation seeking, drug use, and high contact sports

Research question: Studies report associations between sensation seeking and risky behaviour, including drug use, suggesting sensation seeking may involve a vulnerability to health compromising behaviour. Findings on sports as a protective factor against drug use are mixed. The present study was designed to examine whether young adults who participate in high contact sports have an increased likelihood to use drugs, and if the likelihood of drug use is mediated by sensation seeking.Research methods: This quantitative, correlational study included analysis of 463 individuals’ (218 in high contact sports and 245 in non-contact sports) responses to online surveys.Results and findings: Results show that high contact sport is associated with recreational drug use, particularly for males. Sensation seeking is only related to drug use for those engaging in high contact sport.Implications: Sensation seeking may not be useful in predicting drug use directly but can be useful in predicting drug use in high contact sport

Using interpretative phenomenological analysis to inform physiotherapy practice: An introduction with reference to the lived experience of cerebellar ataxia

The attached file is a pre-published version of the full and final paper which can be found at the link below.This article has been made available through the Brunel Open Access Publishing Fund.Qualitative research methods that focus on the lived experience of people with health conditions are relatively underutilised in physiotherapy research. This article aims to introduce interpretative phenomenological analysis (IPA), a research methodology oriented toward exploring and understanding the experience of a particular phenomenon (e.g., living with spinal cord injury or chronic pain, or being the carer of someone with a particular health condition). Researchers using IPA try to find out how people make sense of their experiences and the meanings they attach to them. The findings from IPA research are highly nuanced and offer a fine grained understanding that can be used to contextualise existing quantitative research, to inform understanding of novel or underresearched topics or, in their own right, to provoke a reappraisal of what is considered known about a specified phenomenon. We advocate IPA as a useful and accessible approach to qualitative research that can be used in the clinical setting to inform physiotherapy practice and the development of services from the perspective of individuals with particular health conditions.This article is available through the Brunel Open Access Publishing Fund

Systems Thinking as a Framework for Analyzing Commercial Determinants of Health.

Policy Points: Worldwide, more than 70% of all deaths are attributable to noncommunicable diseases (NCDs), nearly half of which are premature and apply to individuals of working age. Although such deaths are largely preventable, effective solutions continue to elude the public health community. One reason is the considerable influence of the "commercial determinants of health": NCDs are the product of a system that includes powerful corporate actors, who are often involved in public health policymaking. This article shows how a complex systems perspective may be used to analyze the commercial determinants of NCDs, and it explains how this can help with (1) conceptualizing the problem of NCDs and (2) developing effective policy interventions. CONTEXT: The high burden of noncommunicable diseases (NCDs) is politically salient and eminently preventable. However, effective solutions largely continue to elude the public health community. Two pressing issues heighten this challenge: the first is the public health community's narrow approach to addressing NCDs, and the second is the involvement of corporate actors in policymaking. While NCDs are often conceptualized in terms of individual-level risk factors, we argue that they should be reframed as products of a complex system. This article explores the value of a systems approach to understanding NCDs as an emergent property of a complex system, with a focus on commercial actors. METHODS: Drawing on Donella Meadows's systems thinking framework, this article examines how a systems perspective may be used to analyze the commercial determinants of NCDs and, specifically, how unhealthy commodity industries influence public health policy. FINDINGS: Unhealthy commodity industries actively design and shape the NCD policy system, intervene at different levels of the system to gain agency over policy and politics, and legitimize their presence in public health policy decisions. CONCLUSIONS: It should be possible to apply the principles of systems thinking to other complex public health issues, not just NCDs. Such an approach should be tested and refined for other complex public health challenges

Epigenetics and social inequalities in asthma and allergy

Respiratory illnesses, such as asthma and allergy disorders, are disproportionately more common among minority racial/ethnic groups and those of low socioeconomic status. In the United States, asthma prevalence and severity are highest among Puerto Ricans (19.2%), American Indians/Alaska Natives (13%), and Black Americans (12.7%) and higher in families living below the poverty threshold than among those living above it (11% vs 8%–9%).1 Many studies of asthma/allergy inequalities assume that genetic differences underlie racial/ethnic differences in these disorders, pointing to genetic ancestry differences between races, but most genetic variants fail to explain racial/ethnic differences and are usually studied only in White populations.2 In reality, racial and ethnic groups—terms that are often used interchangeably and in overlapping ways—can exhibit varying levels of genetic ancestry, cultural traits, and environmental exposures that all may be entangled together. Thus, any genetic finding differing by race/ethnicity can be confounded by social and environmental factors that also track with different ancestries. However, epigenetic mechanisms (i.e., heritable and stable changes in gene expression) may prove important in explaining these inequalities, as they are influenced by a combination of environmental, social, and genetic factors