Activity-promoting gaming systems in exercise and rehabilitation

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation

The Well Organised Working Environment: A mixed methods study

Background: The English National Health Service Institute for Innovation and Improvement designed a series of programmes called The Productive Series. These are innovations designed to help healthcare staff reduce inefficiency and improve quality, and have been implemented in healthcare organisations in at least 14 different countries. This paper examines an implementation of the first module of the Productive Community Services programme called 'The Well Organised Working Environment'. Objective: The quantitative component aims to identify the quantitative outcomes and impact of the implementation of the Well Organised Working Environment module. The qualitative component aims to describe the contexts, mechanisms and outcomes evident during the implementation, and to consider the implication of these findings for healthcare staff, commissioners and implementation teams. Design: Mixed methods explanatory sequential design. Settings: Community Healthcare Organisation in East Anglia, England. Participants: For the quantitative data, participants were 73 staff members that completed End of Module Assessments. Data from 25 services that carried out an inventory of stock items stored were also analysed. For the qualitative element, participants were 45 staff members working in the organisation during the implementation, and four members of the Productive Community Services Implementation Team. Methods: Staff completed assessments at the end of the module implementation, and the value of items stored by clinical services was recorded. After the programme concluded, semi-structured interviews with staff and a focus group with members of the Productive Community Services implementation team were analysed using Framework Analysis employing the principles of Realist Evaluation. Results: 62.5% respondents (n = 45) to the module assessment reported an improvement in their working environment, 37.5% (n = 27) reported that their working environment stayed the same or deteriorated. The reduction of the value of items stored by services ranged from £4 to £5039 across different services. Results of the qualitative analysis suggests explanations for why the programme worked in some contexts and not others, for instance due to varying levels of management support, and varying levels of resources allocated to carrying out or sustaining the improvement work. Conclusions: Quantitative analysis of data generated during healthcare improvement initiatives can give an impression of the benefits realised, but additional qualitative analysis also provides opportunity for learning to improve future implementations. Targets set by commissioners for innovation should focus on sustaining improvement rather demonstrating one-off benefits, and implementation teams should not let their preconceptions of what will and what will not work prevent them from trying interventions that may benefit staff

Metabolic Profiling of the Diabetic Heart: Towards a Richer Picture

The increasing global prevalence of diabetes has been accompanied by a rise in diabetes-related conditions. This includes diabetic cardiomyopathy, a progressive form of heart disease that occurs with both insulin-dependent (type-1) and insulin-independent (type-2) diabetes and arises in the absence of hypertension or coronary artery disease. Over time, diabetic cardiomyopathy can develop into overt heart failure. Like other forms of cardiomyopathy, diabetic cardiomyopathy is accompanied by alterations in metabolism which could lead to further progression of the pathology, with metabolic derangement postulated to precede functional changes in the diabetic heart. Moreover in the case of type-2 diabetes, underlying insulin resistance is likely to prevent the canonical substrate switch of the failing heart away from fatty acid oxidation towards increased use of glycolysis. Analytical chemistry techniques, collectively known as metabolomics, are useful tools for investigating the condition. In this article, we provide a comprehensive review of those studies that have employed metabolomic techniques, namely chromatography, mass spectrometry and nuclear magnetic resonance spectroscopy, to profile metabolic remodelling in the diabetic heart of human patients and animal models. These studies collectively demonstrate that glycolysis and glucose oxidation are suppressed in the diabetic myocardium and highlight a complex picture regarding lipid metabolism. The diabetic heart typically shows an increased reliance on fatty acid oxidation, yet triacylglycerols and other lipids accumulate in the diabetic myocardium indicating probable lipotoxicity. The application of lipidomic techniques to the diabetic heart has identified specific lipid species that become enriched and which may in turn act as plasma-borne biomarkers for the condition. Metabolomics is proving to be a powerful approach, allowing a much richer analysis of the metabolic alterations that occur in the diabetic heart. Careful physiological interpretation of metabolomic results will now be key in order to establish which aspects of the metabolic derangement are causal to the progression of diabetic cardiomyopathy and might form the basis for novel therapeutic intervention.RCUK and BH

Affective reactions to auditory hallucinations in psychotic, evangelical and control groups

Objectives: Building on recent work on the similarities and differenes in delusional ideation between psychotic and religious populations (Peters, Day, McKenna, and Orbach, 1999), the experiences of auditory hallucinations in psychotic, evangelical and control groups were examined in this study. -- Method: The incidence and subjective experiences of hearing voices were assessed using questionnaire methods in psychotic out-patients, evangelical Christians and controls (non-psychotic, non-evangelical). -- Results: Incidence of auditory hallucinations differend significantly across the three groups with psychotics showing the highest levels and controls the lowest levels. The experiences of the evangelical group were significantly more positive than those of the control group, which in turn were significantly more positive than those of the psychotic group. The most recent experience of hearing voices was rated more positively than the first experience by the psychotic and religious groups but not by the control group. These findings were much stronger for affective reactions to the experiences than for perceptions of the voices. -- Conclusion: These results provide only partial support for the findings of Peters et al. (1999) on differences in delusional ideation and possible reasons for this are discussed. The findings for religious and psychotic individuals are discussed further in terms of interpretational and coping mechanisms

Irish church metalwork of the Romanesque period from the Day collection

This paper examines three important Irish ecclesiastical objects that were once in the collection of Robert Day of Cork. The objects date from the late eleventh and twelfth centuries and include part of a bell-shrine, a figure from a shrine, and a crucifix figure

The Bearnán Chúláin bell-shrine from Glenkeen, Co.Tipperary: an archaeological and historical analysis

This paper presents the first modern detailed account of the Bearnán Chúláin bell-shrine, one of the most important pieces of medieval Church metalwork to survive from Ireland. Originally from Glenkeen, Co. Tipperary, the shrine may be dated to the period of the late-eleventh/early-twelfth century. The paper principally consists of descriptive and historical analyses of the bell- shrine, as well as contextual discussion around its dating and manufacture. The reliquary is compared to a sword handle from Lough Derg and a recent find from England, all of which are attributed to the same workshop that was conceivably under the royal patronage of Muirchertach Ua Briain