Prehospital randomised assessment of a mechanical compression device in cardiac arrest (PaRAMeDIC) trial protocol

Background Survival after out-of-hospital cardiac arrest is closely linked to the quality of CPR, but in real life, resuscitation during pre-hospital care and ambulance transport is often suboptimal. Mechanical chest compression devices deliver consistent chest compressions, are not prone to fatigue and could potentially overcome some of the limitations of manual chest compression. However, there is no high-quality evidence that they improve clinical outcomes, or that they are cost effective. The Pre-hospital Randomised Assessment of a Mechanical Compression Device In Cardiac Arrest (PARAMEDIC) trial is a pragmatic cluster randomised study of the LUCAS-2 device in adult patients with non-traumatic out-of-hospital cardiac arrest. Methods The primary objective of this trial is to evaluate the effect of chest compression using LUCAS-2 on mortality at 30 days post out-of-hospital cardiac arrest, compared with manual chest compression. Secondary objectives of the study are to evaluate the effects of LUCAS-2 on survival to 12 months, cognitive and quality of life outcomes and cost-effectiveness. Methods: Ambulance service vehicles will be randomised to either manual compression (control) or LUCAS arms. Adult patients in out-of-hospital cardiac arrest, attended by a trial vehicle will be eligible for inclusion. Patients with traumatic cardiac arrest or who are pregnant will be excluded. The trial will recruit approximately 4000 patients from England, Wales and Scotland. A waiver of initial consent has been approved by the Research Ethics Committees. Consent will be sought from survivors for participation in the follow-up phase. Conclusion The trial will assess the clinical and cost effectiveness of the LUCAS-2 mechanical chest compression device. Trial Registration: The trial is registered on the International Standard Randomised Controlled Trial Number Registry (ISRCTN08233942)

PromOTing Quality of Life for Individuals with Huntington’s Disease

Objectives of Presentation: Describe the symptoms of Huntington’s disease and their impact on functional performance. Recognize the role of occupational therapy in improving quality of life for individuals with Huntington’s disease. Discuss how occupational therapy interventions for individuals with Huntington’s disease can be applied in a variety of settings. Clinical Question: What is the effectiveness of occupational therapy interventions in improving quality of life for individuals with Huntington’s disease? Presentation: 46 minute

Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke

Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke. Objective. The questions were the following: (1) Is there need for long-dose therapy or is there a mid-treatment plateau? (2) Are the observed gains from the prior-studied protocol retained after treatment? Methods. Single-blind, stratified/randomized design, with 3 applied technology treatment groups, combined with motor learning, for long-duration treatment (300 hours of treatment). Measures were Arm Motor Ability Test time and coordination-function (AMAT-T, AMAT-F, respectively), acquired pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM), acquired similarly with addition of mid-treatment. Findings. There was no group difference in treatment response (P ≥ .16), therefore data were combined for remaining analyses (n = 31; except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and Mid-to-Posttreatment gains of FM were statistically and clinically significant (P \u3c .0001; 4.7 points and P \u3c .001; 5.1 points, respectively), indicating no plateau at 150 hours and benefit of second half of treatment. From baseline to 3moF/U: (1) FM gains were twice the clinically significant benchmark, (2) AMAT-F gains were greater than clinically significant benchmark, and (3) there was statistically significant improvement in FM (P \u3c .0001); AMAT-F (P \u3c .0001); AMAT-T (P \u3c .0001). These gains indicate retained clinically and statistically significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003

Types of Supplementary Aids and Services for Students with Significant Support Needs

Supplementary aids and services have been a provision in special education law since PL 94- 142, however, almost no guidance has been provided to help teams make decisions about their appropriate selection and use. In this exploratory study, we explore the types of supplementary aids and services selected for students with significant support needs using a conventional content analysis of Individual Education Program (IEPs) from 88 students in grades K-12. Results illustrate the wide variation in types of supplementary aids and services chosen for students overall. Curricular accommodations and personnel supports were the most commonly identified supports, while supports to assist students to communicate and make meaning of curriculum (e.g., curricular modifications) were less common, as were less intrusive supports such as peer assisted learning. Implications for policy, practice, and research are provided

A Description of Parent Input in IEP Development Through Analysis of IEP Documents

Parent input in Individualized Education Program (IEP) development is the clear expectation in U.S. education law. Every IEP team must include parents, and their input must be equally considered when developing IEPs. The present study used content analysis of 88 IEPs of students with intellectual and developmental disabilities to explore team membership, concerns parents raised during IEP meetings, and evidence that parent concerns and priorities are reflected in IEP goals and supplementary aids and services. Findings reveal that while parents express a range of concerns and priorities, these are translated into goals or services only two-thirds of the time. We provide implications of these findings for research and practice

Physical activity in young children : a systematic review of parental influences

The primary aim of this review was to identify and evaluate the strength of associations of the key parental factors measured in studies examining early childhood physical activity (PA). A systematic review of the literature, using databases PsychINFO, Medline, Academic Search Complete, PSYCHinfo, and CINHAL, published between January 1986 and March 2011 was conducted; 20 papers were relevant for the current review. While 12 parenting variables were identified, only 5 of these had been investigated sufficiently to provide conclusive findings. There were inconsistencies in the findings involving the social learning variable parental enjoyment and variables involving parental behaviours such as maternal depression and self-efficacy, and rules for sedentary behaviour, and parental perceptions, which included perceived importance of PA, fear of safety, and perception of child&rsquo;s motor competence. Given these inconsistencies, a metaanalysis was conducted to determine whether the method of measuring PA (objective or subjective) influenced the strength of associations between the parental factors and young children&rsquo;s PA. There was no difference in the strength of associations in the studies that used objective or subjective measurement (via parent self-report). Further investigation is needed to clarify and understand the specific parental influences and behaviours that are associated with PA in young children. In particular, longitudinal research is needed to better understand how parental influences and PA levels of children during the formative preschool and early elementary school years are associated.<br /

Vapor pressure and liquid density of fluorinated alcohols:Experimental, simulation and GC-SAFT-VR predictions

The vapor pressure of four liquid 1H,1H-perfluoroalcohols (CF3(CF2)n(CH2)OH, n ¼ 1, 2, 3, 4), often called odd-fluorotelomer alcohols, was measured as a function of temperature between 278 K and 328 K. Liquid densities were also measured for a temperature range between 278 K and 353 K. Molar enthalpies of vaporization were calculated from the experimental data. The results are compared with data from the literature for other perfluoroalcohols as well as with the equivalent hydrogenated alcohols. The results were modeled and interpreted using molecular dynamics simulations and the GC-SAFT-VR equation of state

CCL3 and MMP-9 are induced by TL1A during death receptor 3 (TNFRSF25)-dependent osteoclast function and systemic bone loss

FLC was funded by an Arthritis Research UK PhD studentship (Grant code: 18598) awarded to ASW, ECYW and MDS. JOW was funded by a British Heart Foundation PhD studentship (Reference: FS/11/26/ 28750). ACB's PhD studentship was jointly funded by the School of Medicine and Rheumatology Research Fund (Cardiff University) and LJ's PhD studentship was jointly funded by the School of Medicine and the President's Scholarship Fund (Cardiff University) awarded to ASW. ECYW was additionally funded by MRC Project Grant G0901119.Peer reviewedPublisher PD