Mapping the contribution of Allied Health Professions to the wider public health workforce : a rapid review of evidence-based interventions

Objectives: The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. Study design: A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. Methods: A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Results: Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. Conclusions: This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. Keywords: allied health professions; Applied Health Professionals; evidence-based practice; health improvement; public health; rapid revie

Converting sporting capacity to entrepreneurial capacity: A process perspective

Managing a personal sporting career and conducting an entrepreneurial initiative are two vitally connected processes. Most athletes require a second career and many engage in entrepreneurship. Research on the similarities and differences of the sports career management process and entrepreneurial process with a special emphasis on the necessary capacities will have a ready audience among practitioners. This study begins the task of closing a surprising gap. In entrepreneurship literature, there is (1) growing research on entrepreneurial process and entrepreneurial capacity as the key driver; (2) strong work in generic, descriptive and explanatory modelling of process as a whole and capacity as a sub-process; and (3) the presence of a generic model of entrepreneurial process based of what distinguishes entrepreneurial capacity from other human capacities. In sports management literature, these research strands are virtually absent. The study indicates how the deficiency might be remedied

Investigation of shock waves in explosive blasts using fibre optic pressure sensors

The published version of this article may be accessed at the link below. Copyright @ IOP Publishing, 2006.We describe miniature all-optical pressure sensors, fabricated by wafer etching techniques, less than 1 mm(2) in overall cross-section with rise times in the mu s regime and pressure ranges typically 900 kPa (9 bar). Their performance is suitable for experimental studies of the pressure-time history for test models exposed to shocks initiated by an explosive charge. The small size and fast response of the sensors promises higher quality data than has been previously available from conventional electrical sensors, with potential improvements to numerical models of blast effects. Results from blast tests are presented in which up to six sensors were multiplexed, embedded within test models in a range of orientations relative to the shock front.Support from the UK Engineering&Physical Sciences Research Council and Dstl Fort Halstead through the MoD Joint Grants Scheme are acknowledged. WN MacPherson is supported by an EPSRC Advanced Research Fellowship

Exploring population responses to environmental change when there is never enough data: a factor analytic approach

© 2018 The Authors. Methods in Ecology and Evolution published by John Wiley & Sons Ltd on behalf of British Ecological Society Temporal variability in the environment drives variation in vital rates, with consequences for population dynamics and life-history evolution. Integral projection models (IPMs) are data-driven structured population models widely used to study population dynamics and life-history evolution in temporally variable environments. However, many datasets have insufficient temporal replication for the environmental drivers of vital rates to be identified with confidence, limiting their use for evaluating population level responses to environmental change. Parameter selection, where the kernel is constructed at each time step by randomly selecting the time-varying parameters from their joint probability distribution, is one approach to including stochasticity in IPMs. We consider a factor analytic (FA) approach for modelling the covariance matrix of time-varying parameters, whereby latent variable(s) describe the covariance among vital rate parameters. This decreases the number of parameters to estimate and, where the covariance is positive, the latent variable can be interpreted as a measure of environmental quality. We demonstrate this using simulation studies and two case studies. The simulation studies suggest the FA approach provides similarly accurate estimates of stochastic population growth rate to estimating an unstructured covariance matrix. We demonstrate how the latent parameter can be perturbed to show how selection on reproductive delays in the monocarp Carduus nutans changes under different environmental conditions. We develop a demographic model of the fire dependent herb Eryngium cuneifolium to show how a putative driver of the variation in environmental quality can be incorporated with the addition of a single parameter. Using perturbation analyses we determine optimal management strategies for this species. This approach estimates fewer parameters than previous approaches and allows novel eco-evolutionary insights. Predictions on population dynamics and life-history evolution under different environmental conditions can be made without necessarily identifying causal factors. Putative environmental drivers can be incorporated with relatively few parameters, allowing for predictions on how populations will respond to changes in the environment

Changes in muscle activity and stature recovery after active rehabilitation for chronic low back pain

Patients with low back pain often demonstrate elevated paraspinal muscle activity compared to asymptomatic controls. This hyperactivity has been associated with a delayed rate of stature recovery following spinal loading tasks. The aim of this study was to investigate the changes in muscle activity and stature recovery in patients with chronic low back pain following an active rehabilitation programme. The body height recovery over a 40-min unloading period was assessed via stadiometry and surface electromyograms were recorded from the paraspinal muscles during standing. The measurements were repeated after patients had attended the rehabilitation programme and again at a six-month follow-up. Analysis was based on 17 patients who completed the post-treatment analysis and 12 of these who also participated in the follow-up. By the end of the six months, patients recovered significantly more height during the unloading session than at their initial visit (ES = 1.18; P < 0.01). Greater stature recovery immediately following the programme was associated with decreased pain (r = −0.55; P = 0.01). The increased height gain after six months suggests that delayed rates of recovery are not primarily caused by disc degeneration. Muscle activity did not decrease after treatment, perhaps reflecting a period of adaptation or altered patterns of motor control

The Ulakhan fault surface rupture and the seismicity of the Okhotsk–North America plate boundary

New field work, combined with analysis of high-resolution aerial photographs, digital elevation models, and satellite imagery, has identified an active fault that is traceable for ∼90&thinsp;km across the Seymchan Basin and is part of the Ulakhan fault system, which is believed to form the Okhotsk–North America plate boundary. Age dating of alluvial fan sediments in a channel system that is disturbed by fault activity suggests the current scarp is a result of a series of large earthquakes (≥Mw 7.5) that have occurred since 11.6±2.7&thinsp;ka. A possible channel feature offset by 62±4&thinsp;m associated with these sediments yields a slip rate of 5.3±1.3&thinsp;mm&thinsp;yr−1, in broad agreement with rates suggested from global plate tectonics. Our results clearly identify the Ulakhan fault as the Okhotsk–North America plate boundary and show that tectonic strain release is strongly concentrated on the boundaries of Okhotsk. In light of our results, the likelihood of recurrence of Mw 7.5 earthquakes is high, suggesting a previously underestimated seismic hazard across the region.</p

AIGO: towards a unified framework for the analysis and the inter-comparison of GO functional annotations

BACKGROUND: In response to the rapid growth of available genome sequences, efforts have been made to develop automatic inference methods to functionally characterize them. Pipelines that infer functional annotation are now routinely used to produce new annotations at a genome scale and for a broad variety of species. These pipelines differ widely in their inference algorithms, confidence thresholds and data sources for reasoning. This heterogeneity makes a comparison of the relative merits of each approach extremely complex. The evaluation of the quality of the resultant annotations is also challenging given there is often no existing gold-standard against which to evaluate precision and recall. RESULTS: In this paper, we present a pragmatic approach to the study of functional annotations. An ensemble of 12 metrics, describing various aspects of functional annotations, is defined and implemented in a unified framework, which facilitates their systematic analysis and inter-comparison. The use of this framework is demonstrated on three illustrative examples: analysing the outputs of state-of-the-art inference pipelines, comparing electronic versus manual annotation methods, and monitoring the evolution of publicly available functional annotations. The framework is part of the AIGO library (http://code.google.com/p/aigo) for the Analysis and the Inter-comparison of the products of Gene Ontology (GO) annotation pipelines. The AIGO library also provides functionalities to easily load, analyse, manipulate and compare functional annotations and also to plot and export the results of the analysis in various formats. CONCLUSIONS: This work is a step toward developing a unified framework for the systematic study of GO functional annotations. This framework has been designed so that new metrics on GO functional annotations can be added in a very straightforward way

Atherogenic Lipid Stress Induces Platelet Hyperactivity Through CD36-Mediated Hyposensitivity To Prostacyclin-; The Role Of Phosphodiesterase 3A

Prostacyclin (PGI2) controls platelet activation and thrombosis through a cyclic adenosine monophosphate (cAMP) signalling cascade. However, in patients with cardiovascular diseases this protective mechanism fails for reasons that are unclear. Using both pharmacological and genetic approaches we describe a mechanism by which oxidised low density lipoproteins (oxLDL) associated with dyslipidaemia promote platelet activation through impaired PGI2 sensitivity and diminished cAMP signalling. In functional assays using human platelets, oxLDL modulated the inhibitory effects of PGI2, but not a PDE-insensitive cAMP analogue, on platelet aggregation, granule secretion and in vitro thrombosis. Examination of the mechanism revealed that oxLDL promoted the hydrolysis of cAMP through the phosphorylation and activation of phosphodiesterase 3A (PDE3A), leading to diminished cAMP signalling. PDE3A activation by oxLDL required Src family kinases, Syk and protein kinase C. The effects of oxLDL on platelet function and cAMP signalling were blocked by pharmacological inhibition of CD36, mimicked by CD36-specific oxidised phospholipids and ablated in CD36-/- murine platelets. The injection of oxLDL into wild type mice strongly promoted FeCl3 induced carotid thrombosis in vivo, which was prevented by pharmacological inhibition of PDE3A. Furthermore, blood from dyslipidaemic mice was associated with increased oxidative lipid stress, reduced platelet sensitivity to PGI2 ex vivo and diminished PKA signalling. In contrast, platelet sensitivity to a PDE-resistant cAMP analogue remained normal. Genetic deletion of CD36, protected dyslipidaemic animals from PGI2 hyposensitivity and restored PKA signalling. These data suggest that CD36 can translate atherogenic lipid stress into platelet hyperactivity through modulation of inhibitory cAMP signalling.  

Motor phenotypes, medication and mood: further associations with impulsive behaviours in Parkinson's disease

BACKGROUND: Dopaminergic drugs are the primary risk factor for Impulse Control Behaviours (ICB) in Parkinson's disease (PD), others being early-onset disease and gender. OBJECTIVE: This report further explores ICB symptom relationships with motor and mood phenotypes, the complex relationship with dopaminergic medications, and hypothesizes a model with potential clinical implications. METHODS: Data from 500 PD patients were analyzed. Hypersexuality, gambling and shopping behaviour were assessed using selected questions from the Minnesota Impulsive Disorders Interview questionnaire. Local questions assessed hobbyism. Motor characteristics considered were akinetic-rigid/gait disturbance (PIGD) and 'non-PIGD' phenotypes, motor severity, motor progression, and presence/absence of motor fluctuations. Other variables included anxiety, depression, current levodopa and agonist use, age, gender and cognition. RESULTS: Overall, ICB symptom frequency was 17.8%. There was no relationship between PIGD/non-PIGD motor phenotypes and ICB symptoms. Those with ICB symptoms had higher total combined levodopa/agonist equivalent intake, but not current agonist-only equivalent intake. ICB symptoms were reported by 23.1% of those taking combined levodopa and agonist compared to 19.2% on agonist monotherapy and 11.6% levodopa monotherapy. Compared with non-ICB patients, patients with ICB symptoms were more likely to show an anxious mood phenotype, reported more motor fluctuations, and were younger. CONCLUSIONS: Both PIGD and non-PIGD phenotypes are equally affected. Dose-related risk applies to total anti-parkinsonian medication and not just current agonist-only. Anxious mood phenotypes may carry increased risk. A role of anxiety, either as a marker of risk, indirect causal factor, or maintaining factor is incorporated into a preliminary model. We discuss implications for clinical management