Crossing boundaries: the perceived impact of disabled fitness instructors in the gym

Objectives For disabled individuals, the gym is perceived to be an inaccessible space to exercise due to the deeply embedded ableism within this environment. This study uniquely explored how disabled gym instructors perceived they impacted the gym environment and the possibilities of making the gym a more inclusive space for disabled people to exercise. Design We used an inductive, qualitative design whereby ten disabled gym instructors were purposefully sampled. Methods Data were rigorously collected through semi-structured interviews totalling 35 h, transcribed verbatim, and subject to thematic analysis. Results Participants perceived they made three key impacts in the gym. First, they believed they promoted the gym as a more inclusive environment through helping construct a more accessible physical space, embodying an alternate way of being and providing a relatable narrative. Second, instructors believed their own unique understanding of disability improved their capacity to relate to disabled gym clients by instilling a sense of camaraderie and acting as an aspirational future self. Third, participants felt they enhanced applied practice for training disabled clients through creativity in training and supporting non-disabled instructors. Conclusion This article makes a significant contribution to knowledge by highlighting that disabled gym instructors can play a vital role in promoting a more inclusive space to exercise. It also highlights that to increase gym use amongst disabled populations, efforts should consider the potential beneficial impacts of disabled gym instructors in relation to promoting health and well-being

Disability and the gym: experiences, barriers and facilitators of gym use for individuals with physical disabilities

Purpose: Individuals with physical disabilities are among the most inactive population in society, arguably due to the lack of suitable environments to exercise. The gym is a space dedicated to improving physical fitness in a controlled environment with specialized equipment and qualified instructors. The feasibility of using this space to promote health to this population, however, is yet to be established. Method: Over an 18-month period, 21 people with physical disabilities were interviewed regarding their experiences in the gym. Data were collected using semi-structured interviews, transcribed verbatim, and subject to thematic analysis. Results: Four broad themes were identified: (1) experiencing enhanced well-ness, (2) perceived conflict between gym values and disability, (3) influence of a previous gym identity, and (4) experiences of psycho-emotional disablism. Conclusions: Participants were perceived to experience a variety of health benefits; however, they also experienced many barriers such as not aligning to the cultural norms of the gym, limited interpretations of health, oppressive messages from the built environment, and negative relational interactions. While there is potential for the gym to be used as a place to promote health, more must be done to foster an inclusive atmosphere in this space

Models and Materials for Exercise Promotion in Comprehensive Multiple Sclerosis Care: Completion of the ‘Exercise in Medicine’ Development Process

Purpose: Health care providers have highlighted the need for tools and resources that support promotion of exercise behavior within comprehensive multiple sclerosis (MS) care. This study involved a final quality improvement evaluation of exercise promotion models and materials for inclusion within this setting. Methods and materials: Our research team distributed a paper-based survey containing Likert scales, open answer questions, and copies of the models for editing. We distributed this survey among health care providers across the United States. We conducted a novel mixed-methods analysis evaluating quantitative, qualitative, and creative data. Results: We received completed surveys from 13 health care providers who strongly rated the clarity and applicability of the models and materials, and reported that no major improvements were necessary. The minor improvements were specific per comprehensive MS care center. The feedback indicated that the “Exercise in Medicine” models and materials are guides such that the processes should be integrated into real world practice by amending roles and responsibilities with the team members and structure per comprehensive MS care center. Conclusion: This paper presents finalized models and materials for exercise promotion within comprehensive MS care that are ready to be tested for feasibility and efficacy in a clinical trial

Cross-Neutralisation of Novel Bombali Virus by Ebola Virus Antibodies and Convalescent Plasma Using an Optimised Pseudotype-Based Neutralisation Assay.

Ebolaviruses continue to pose a significant outbreak threat, and while Ebola virus (EBOV)-specific vaccines and antivirals have been licensed, efforts to develop candidates offering broad species cross-protection are continuing. The use of pseudotyped virus in place of live virus is recognised as an alternative, safer, high-throughput platform to evaluate anti-ebolavirus antibodies towards their development, yet it requires optimisation. Here, we have shown that the target cell line impacts neutralisation assay results and cannot be selected purely based on permissiveness. In expanding the platform to incorporate each of the ebolavirus species envelope glycoprotein, allowing a comprehensive assessment of cross-neutralisation, we found that the recently discovered Bombali virus has a point mutation in the receptor-binding domain which prevents entry into a hamster cell line and, importantly, shows that this virus can be cross-neutralised by EBOV antibodies and convalescent plasma

Somatotyping of Division I Athletes

Somatotyping has previously examined athletes\u27 genetic morphology. Categorization of somatotyping can be utilized in athletes for specialized, adaptive sports performance. PURPOSE: The purpose of this study was to report somatotyping differences (ectomorph, mesomorph, and endomorph) in selected Division I athletes. METHOD: 39 male football athletes and seven female softball Division I athletes were recruited for this investigation. Height (m), weight (kg), waist-to-hip ratio (cm), and a 4-site skinfold measurement was collected. Skinfold locations were recorded from the triceps (mm), subscapular (mm), supraspinal (mm), and the medial calf (mm). Biepicondylar breadth measures of the humerus (cm), and the femur (cm) were recorded at a respective 90°. Additionally, the girth of the subject’s dominant upper arm (cm) and dominant calf (cm) were recorded. All measurement locations were taken from the Heath-Carter Anthropometric protocol, respectfully. The Heath Carter Somatotype Worksheet consists of a rating scale that is based on a 3-component categorization. All measures are considered when calculating a participant\u27s score. Scores between .5 and 2.5 are low, 3 to 5 are moderate, 5.5 to 7 are high and anything over a 7.5 is considered very high. The first component calculated scores of endomorphy, the second calculated mesomorphy scores, and the last component calculated ectomorph scores. Using these measurements, equations are used to determine a participant’s score to a specific somatotype. The athletes\u27 numbers were then processed and plotted on a 2-D graph plotting the somatotype (X= ectomorph-endomorph, Y=2 x mesomorphy- (endomorphy+ectomorph)). RESULTS: There was a clear indication that somatotyping had variety based on sports and position specialization in football athletes. Football athletes consisted of 6 endomorphs, 30 mesomorphs, and 3 ectomorphs, while softball athletes consisted of 7 meso-endomorphs. CONCLUSION: Due to the anthropometric position differences in male football athletes there was a considerable amount of variety and lack of specificity, while the female softball athletes consisted of a lesser variety in anthropometric measures

d-Tubocurarine and Berbamine: Alkaloids That Are Permeant Blockers of the Hair Cell's Mechano-Electrical Transducer Channel and Protect from Aminoglycoside Toxicity

Aminoglycoside antibiotics are widely used for the treatment of life-threatening bacterial infections, but cause permanent hearing loss in a substantial proportion of treated patients. The sensory hair cells of the inner ear are damaged following entry of these antibiotics via the mechano-electrical transducer (MET) channels located at the tips of the hair cell’s stereocilia. d-Tubocurarine (dTC) is a MET channel blocker that reduces the loading of gentamicin-Texas Red (GTTR) into rat cochlear hair cells and protects them from gentamicin treatment. Berbamine is a structurally related alkaloid that reduces GTTR labeling of zebrafish lateral-line hair cells and protects them from aminoglycoside-induced cell death. Both compounds are thought to reduce aminoglycoside entry into hair cells through the MET channels. Here we show that dTC (≥6.25 µM) or berbamine (≥1.55 µM) protect zebrafish hair cells in vivo from neomycin (6.25 µM, 1 h). Protection of zebrafish hair cells against gentamicin (10 µM, 6 h) was provided by ≥25 µM dTC or ≥12.5 µM berbamine. Hair cells in mouse cochlear cultures are protected from longer-term exposure to gentamicin (5 µM, 48 h) by 20 µM berbamine or 25 µM dTC. Berbamine is, however, highly toxic to mouse cochlear hair cells at higher concentrations (≥30 µM) whilst dTC is not. The absence of toxicity in the zebrafish assays prompts caution in extrapolating results from zebrafish neuromasts to mammalian cochlear hair cells. MET current recordings from mouse outer hair cells (OHCs) show that both compounds are permeant open-channel blockers, rapidly and reversibly blocking the MET channel with half-blocking concentrations of 2.2 µM (dTC) and 2.8 µM (berbamine) in the presence of 1.3 mM Ca2+ at −104 mV. Berbamine, but not dTC, also blocks the hair cell’s basolateral K + current, IK,neo, and modeling studies indicate that berbamine permeates the MET channel more readily than dTC. These studies reveal key properties of MET-channel blockers required for the future design of successful otoprotectants

Family satisfaction with critical care in the UK: a multicentre cohort study.

OBJECTIVE: To assess family satisfaction with intensive care units (ICUs) in the UK using the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire, and to investigate how characteristics of patients and their family members impact on family satisfaction. DESIGN: Prospective cohort study nested within a national clinical audit database. SETTING: Stratified, random sample of 20 adult general ICUs participating in the Intensive Care National Audit & Research Centre Case Mix Programme. PARTICIPANTS: Family members of patients staying at least 24 hours in ICU were recruited between May 2013 and June 2014. INTERVENTIONS: Consenting family members were sent a postal questionnaire 3 weeks after the patient died or was discharged from ICU. Up to four family members were recruited per patient. MAIN OUTCOME MEASURES: Family satisfaction was measured using the FS-ICU-24 questionnaire. MAIN RESULTS: A total of 12 346 family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. Overall and domain-specific family satisfaction scores were high (mean overall family satisfaction 80, satisfaction with care 83, satisfaction with information 76 and satisfaction with decision-making 73 out of 100) but varied significantly across adult general ICUs studied and by whether the patient survived ICU. For family members of ICU survivors, characteristics of both the family member (age, ethnicity, relationship to patient (next-of-kin and/or lived with patient) and visit frequency) and the patient (acute severity of illness and receipt of invasive mechanical ventilation) were significant determinants of family satisfaction, whereas, for family members of ICU non-survivors, only patient characteristics (age, acute severity of illness and duration of stay) were significant. CONCLUSIONS: Overall family satisfaction in UK adult general ICUs was high but varied significantly. Adjustment for differences in family member/patient characteristics is important to avoid falsely identifying ICUs as statistical outliers. TRIAL REGISTRATION NUMBER: ISRCTN47363549

Design, synthesis and biological evaluation of a new series of carvedilol derivatives that protect sensory hair cells from aminoglycoside-induced damage by blocking the mechanoelectrical transducer channel

Aminoglycosides (AGs) are broad-spectrum antibiotics used for the treatment of serious bacterial infections but have use-limiting side effects including irreversible hearing loss. Here, we assessed the otoprotective profile of carvedilol in mouse cochlear cultures and in vivo zebrafish assays and investigated its mechanism of protection which, we found, may be mediated by a block of the hair cell’s mechanoelectrical transducer (MET) channel, the major entry route for the AGs. To understand the full otoprotective potential of carvedilol, a series of 18 analogues were prepared and evaluated for their effect against AG-induced damage as well as their affinity for the MET channel. One derivative was found to confer greater protection than carvedilol itself in cochlear cultures and also to bind more tightly to the MET channel. At higher concentrations, both carvedilol and this derivative were toxic in cochlear cultures but not in zebrafish, suggesting a good therapeutic window under in vivo conditions

Maintenance of complex I and its supercomplexes by NDUF-11 is essential for mitochondrial structure, function and health

Mitochondrial supercomplexes form around a conserved core of monomeric complex I and dimeric complex III; wherein a subunit of the former, NDUFA11, is conspicuously situated at the interface. We identified nduf-11 (B0491.5) as encoding the Caenorhabditis elegans homologue of NDUFA11. Animals homozygous for a CRISPR-Cas9-generated knockout allele of nduf-11 arrested at the second larval (L2) development stage. Reducing (but not eliminating) expression using RNAi allowed development to adulthood, enabling characterisation of the consequences: destabilisation of complex I and its supercomplexes and perturbation of respiratory function. The loss of NADH dehydrogenase activity was compensated by enhanced complex II activity, with the potential for detrimental reactive oxygen species (ROS) production. Cryo-electron tomography highlighted aberrant morphology of cristae and widening of both cristae junctions and the intermembrane space. The requirement of NDUF-11 for balanced respiration, mitochondrial morphology and development presumably arises due to its involvement in complex I and supercomplex maintenance. This highlights the importance of respiratory complex integrity for health and the potential for its perturbation to cause mitochondrial disease. This article has an associated First Person interview with Amber Knapp-Wilson, joint first author of the paper