“WALK30X5”:A feasibility study of a physiotherapy walking programme for people with mild to moderate musculoskeletal conditions

Objectives: To explore the feasibility of delivering and evaluating a web-based walking intervention for people with long term musculoskeletal conditions (LTMCs), to determine its acceptability and the feasibility of conducting a definitive trial.  Design: Prospective randomised feasibility study, with blind outcome assessment at baseline, 3 and 6 months. Setting: Hospital based physiotherapy service. Participants: Forty one adults referred for assessment and advice for any mild/moderate LTMCs. doing <120 minutes of moderate intensity activity per week.  Interventions: Participants randomised to: 1. Usual care: one usual physiotherapy advice and assessment session, including setting a physical activity goal and one follow up session (8 weeks). 2. “Walk30 × 5”: session one, usual care plus intervention of walking programme. Participants were shown the website and podcasts and practiced how to use them. One follow up session (8 weeks). Outcome measures: Primary: timed six minute walk test (T6MWT). Secondary: step count, self-reported pain, fatigue, mood, self-efficacy, happiness, objective blood pressure, peak expiratory flow rate, and self-report and accelerometer measured physical activity.  Results: Recruitment target achieved. No adverse events occurred. Adherence was high and the intervention acceptable. Loss to follow up n = 3 (7%) at 3 months, n = 8 (20%) at 6 months. T6MWT and step count proved suitable outcomes, unlike accelerometry. Estimated sample size for a definitive trial is 216.  Conclusions: “Walk30 × 5” is ready for evaluation in a future, appropriately powered (n = 216), phase III trial. If effective, the intervention will provide a cheap, highly accessible intervention to enable people with mild/moderate LTMCs to achieve UK physical activity guidelines.  Clinical Trial Registration Number: ISRCTN78581097

Methods for identifying plant materials in Māori and Pacific textiles

Investigating the range of plant species used in Māori and Pacific textiles can help to understand the diversity and relationships among whatu and raranga techniques and art forms. Although the style and construction of Māori and Pacific textile artefacts often give clues as to the plant species used, positive species identification is not always possible from visual inspection. This may be due to the age and condition of the artefact, or effects of leaf processing such as splitting, softening, stripping or dying. A range of laboratory methods and published resources are however available to help with the identification process. Understanding the internal and surface anatomy of raw leaf material (e.g. Carr and Cruthers 2007; Carr et. al. 2009), the effects of leaf preparation for weaving on leaf anatomy (e.g. King 2003) and the expected condition of specimens sampled from artefacts can aid the interpretation of data collected in the laboratory. The most appropriate method of specimen preparation is another important consideration. This paper provides a review of microscopy and tomography techniques and online resources, which have been trialled and implemented in the Clothing and Textile Sciences Department at the University of Otago for the identification of plant species of interest in New Zealand and the Pacific. The advantages and disadvantages of these techniques and resources for identifying plant materials in artefacts will be discussed

The current landscape of software tools for the climate-sensitive infectious disease modelling community

Climate-sensitive infectious disease modelling is crucial for public health planning and is underpinned by a complex network of software tools. We identified only 37 tools that incorporated both climate inputs and epidemiological information to produce an output of disease risk in one package, were transparently described and validated, were named (for future searching and versioning), and were accessible (ie, the code was published during the past 10 years or was available on a repository, web platform, or other user interface). We noted disproportionate representation of developers based at North American and European institutions. Most tools (n=30 [81%]) focused on vector-borne diseases, and more than half (n=16 [53%]) of these tools focused on malaria. Few tools (n=4 [11%]) focused on food-borne, respiratory, or water-borne diseases. The under-representation of tools for estimating outbreaks of directly transmitted diseases represents a major knowledge gap. Just over half (n=20 [54%]) of the tools assessed were described as operationalised, with many freely available online.Peer Reviewed"Article signat per 12 autors/es: Sadie J Ryan, PhD * Catherine A Lippi, Talia Caplan, Avriel Diaz, Willy Dunbar, Shruti Grover, Simon Johnson, Rebecca Knowles, Prof Rachel Lowe, Bilal A Mateen, Madeleine C Thomson, Anna M Stewart-Ibarra"Postprint (published version

Multi-nuclear, high-pressure, operando FlowNMR spectroscopic study of Rh/PPh3 – catalysed hydroformylation of 1-hexene

The hydroformylation of 1-hexene with 12 bar of 1 : 1 H2/CO in the presence of the catalytic system [Rh(acac)(CO)2]/PPh3 was successfully studied by real-time multinuclear high-resolution FlowNMR spectroscopy at 50 °C. Quantitative reaction progress curves that yield rates as well as chemo- and regioselectivities have been obtained with varying P/Rh loadings. Dissolved H2 can be monitored in solution to ensure true operando conditions without gas limitation. 31P{1H} and selective excitation 1H pulse sequences have been periodically interleaved with 1H FlowNMR measurements to detect Rh–phosphine intermediates during the catalysis. Stopped-flow experiments in combination with diffusion measurements and 2D heteronuclear correlation experiments showed the known tris-phosphine complex [RhH(CO)(PPh3)3] to generate rapidly exchanging isomers of the bis-phosphine complex [Rh(CO)2(PPh3)2] under CO pressure that directly enter the catalytic cycle. A new mono-phosphine acyl complex has been identified as an in-cycle reaction intermediate

Consolidation of black-dyed Maori textile artefacts: Evaluating the efficacy of sodium alginate

Black-dyed artefacts are found in museums worldwide, many produced using an iron-tannate compound. Deterioration of iron-tannate dyed artefacts is an international preservation issue: in New Zealand the deterioration of paru (iron-tannate) dyed Māori textiles is widespread. This article reports experimental work testing the efficacy of sodium alginate, a consolidant developed for deteriorated paru-dyed muka (fibre from harakeke; Phormium tenax). The colour stability, strength retention, and acidity of paru-dyed muka consolidated with sodium alginate (0.25, 0.5, and 1% w/v in water) was tested pre- and post-artificial light ageing. This study found that sodium alginate had no negative effect on paru-dyed muka and in some cases provided benefit. Interestingly, the colour of paru-dyed muka is substantially more stable in UV-filtered light than previously recognised. Also microfading results were in agreement with visual assessments of colour change at 1 Mlux hour exposure, providing confidence in this relatively new technique to assess colour change

Paracetamol use in early life and asthma: prospective birth cohort study

Objective To determine if use of paracetamol in early life is an independent risk factor for childhood asthma

Nonlinear and delayed impacts of climate on dengue risk in Barbados: A modelling study

Background: Over the last 5 years (2013–2017), the Caribbean region has faced an unprecedented crisis of co-occurring epidemics of febrile illness due to arboviruses transmitted by the Aedes sp. mosquito (dengue, chikungunya, and Zika). Since 2013, the Caribbean island of Barbados has experienced 3 dengue outbreaks, 1 chikungunya outbreak, and 1 Zika fever outbreak. Prior studies have demonstrated that climate variability influences arbovirus transmission and vector population dynamics in the region, indicating the potential to develop public health interventions using climate information. The aim of this study is to quantify the nonlinear and delayed effects of climate indicators, such as drought and extreme rainfall, on dengue risk in Barbados from 1999 to 2016. Methods and findings: Distributed lag nonlinear models (DLNMs) coupled with a hierarchal mixed-model framework were used to understand the exposure–lag–response association between dengue relative risk and key climate indicators, including the standardised precipitation index (SPI) and minimum temperature (Tmin). The model parameters were estimated in a Bayesian framework to produce probabilistic predictions of exceeding an island-specific outbreak threshold. The ability of the model to successfully detect outbreaks was assessed and compared to a baseline model, representative of standard dengue surveillance practice. Drought conditions were found to positively influence dengue relative risk at long lead times of up to 5 months, while excess rainfall increased the risk at shorter lead times between 1 and 2 months. The SPI averaged over a 6-month period (SPI-6), designed to monitor drought and extreme rainfall, better explained variations in dengue risk than monthly precipitation data measured in millimetres. Tmin was found to be a better predictor than mean and maximum temperature. Furthermore, including bidimensional exposure–lag–response functions of these indicators—rather than linear effects for individual lags—more appropriately described the climate–disease associations than traditional modelling approaches. In prediction mode, the model was successfully able to distinguish outbreaks from nonoutbreaks for most years, with an overall proportion of correct predictions (hits and correct rejections) of 86% (81%:91%) compared with 64% (58%:71%) for the baseline model. The ability of the model to predict dengue outbreaks in recent years was complicated by the lack of data on the emergence of new arboviruses, including chikungunya and Zika. Conclusion: We present a modelling approach to infer the risk of dengue outbreaks given the cumulative effect of climate variations in the months leading up to an outbreak. By combining the dengue prediction model with climate indicators, which are routinely monitored and forecasted by the Regional Climate Centre (RCC) at the Caribbean Institute for Meteorology and Hydrology (CIMH), probabilistic dengue outlooks could be included in the Caribbean Health-Climatic Bulletin, issued on a quarterly basis to provide climate-smart decision-making guidance for Caribbean health practitioners. This flexible modelling approach could be extended to model the risk of dengue and other arboviruses in the Caribbean region

Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials

Background: Physiotherapy has long been a routine component of patient rehabilitation following hip joint replacement. The purpose of this systematic review was to evaluate the effectiveness of physiotherapy exercise after discharge from hospital on function, walking, range of motion, quality of life and muscle strength, for osteoarthritic patients following elective primary total hip arthroplasty. Methods: Design: Systematic review, using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions and the Quorom Statement. Database searches: AMED, CINAHL, EMBASE, KingsFund, MEDLINE, Cochrane library (Cochrane reviews, Cochrane Central Register of Controlled Trials, DARE), PEDro, The Department of Health National Research Register. Handsearches: Physiotherapy, Physical Therapy, Journal of Bone and Joint Surgery (Britain) Conference Proceedings. No language restrictions were applied. Selection: Trials comparing physiotherapy exercise versus usual/standard care, or comparing two types of relevant exercise physiotherapy, following discharge from hospital after elective primary total hip replacement for osteoarthritis were reviewed. Outcomes: Functional activities of daily living, walking, quality of life, muscle strength and range of hip joint motion. Trial quality was extensively evaluated. Narrative synthesis plus meta-analytic summaries were performed to summarise the data. Results: 8 trials were identified. Trial quality was mixed. Generally poor trial quality, quantity and diversity prevented explanatory meta-analyses. The results were synthesised and meta-analytic summaries were used where possible to provide a formal summary of results. Results indicate that physiotherapy exercise after discharge following total hip replacement has the potential to benefit patients. Conclusion: Insufficient evidence exists to establish the effectiveness of physiotherapy exercise following primary hip replacement for osteoarthritis. Further well designed trials are required to determine the value of post discharge exercise following this increasingly common surgical procedure