Physical activity, sedentary behavior, and barriers to exercise in people living with dystonia

© 2019 McCambridge, Meiring and Bradnam. Background: Dystonia is a neurological movement disorder that presents as sustained or intermittent involuntary muscle contractions causing abnormal postures and movements. Knowledge of dystonia is mostly at the impairment level with minimal understanding of activity and participation limitations. Physical activity (PA) is an important aspect of neurological disease management, with wide-ranging benefits for overall health and quality of life. No studies have quantified PA and sedentary behavior (SB), nor explored barriers to being physically active in people with dystonia. Methods: Participants diagnosed with any form of dystonia completed a mixed-methods anonymous online survey on activity behaviors. The International Physical Activity Questionnaire (IPAQ) and Adult Sedentary Behavior Questionnaire (SBQ) assessed self-reported PA and SB. Barriers to exercise engagement were investigated according to the five-factor social-ecological framework and dystonia-specific questions regarding the impact of exercise on symptoms were included. Results: Two-hundred and sixty-three participants consented to the study (mean (SD) age = 55 (13) years, 76% Female). A large proportion of respondents (40%) reported living with cervical dystonia (CD). Overall, the median (IQR) time spent in walking, moderate, and vigorous activity was 60 (0–120), 120 (15–300), and 0 (0–13) min/day, respectively. SB time during weekdays was 285.0 (157.5–465.0) min/day and 345.0 (195.0–502.5) min/day on weekends. Fifty-five percent of participants were dissatisfied with their current level of PA and 75% reported dystonia had decreased their level of PA. Fifty-seven percent found their symptoms were worsened during exercise though the after-effects on symptoms varied. Fatigue, motor symptoms, pain, and poor balance were commonly cited limiting factors. Qualitative and quantitative data indicated difficulties with more vigorous intensity activity. The common barriers to engagement were personal and governmental factors, such as physical impairments, lack of funding and lack of trained exercise professionals. Conclusion: While more than half of respondents indicated they were not satisfied with their current level of PA, and exercise primarily worsened their dystonia symptoms, most participants were meeting the minimum guidelines. Future studies should incorporate robust objective methods of PA and SB measurement and explore the causal mechanisms underpinning exercise-induced aggravation of dystonic symptoms to further enhance life participation of people living with dystonia

Deriving Laws for Developing Concurrent Programs in a Rely-Guarantee Style

In this paper we present a theory for the refinement of shared-memory concurrent algorithms from specifications. Our approach avoids restrictive atomicity contraints. It provides a range of constructs for specifying concurrent programs and laws for refining these to code. We augment pre and post condition specifications with Jones' rely and guarantee conditions, which we encode as commands within a wide-spectrum language. Program components are specified using either partial and total correctness versions of end-to-end specifications. Operations on shared data structures and atomic machine operations (e.g. compare-and-swap) are specified using an atomic specification command. All the above constructs are defined in terms of a simple core language, based on four primitive commands and a handful of operators, and for which we have developed an extensive algebraic theory in Isabelle/HOL. For shared memory programs, expression evaluation is subject to fine-grained interference and we have avoided atomicity restrictions other than for read and write of primitive types (words). Expression evaluation and assignment commands are also defined in terms of our core language primitives, allowing laws for reasoning about them to be proven in the theory. Control structures such as conditionals, recursion and loops are all defined in terms of the core language. In developing the laws for refining to such structures from specifications we have taken care to develop laws that are as general as possible; our laws are typically more general than those found in the literature. In developing our concurrent refinement theory we have taken care to focus on the algebraic properties of our commands and operators, which has allowed us to reuse algebraic theories, including well-known theories, such as lattices and boolean algebra, as well as programming-specific algebras, such as our synchronous algebra

Antimicrobial resistance patterns in a Port Elizabeth hospital

Antibiotic resistance in clinical bacterial isolates remains an ongoing problem requiring continuous monitoring to effect some form of control. Comparative studies have not been previously reported for the Eastern Cape Region, South Africa and this study was undertaken to monitor resistance patterns in clinical isolates from Provincial Hospital, Port Elizabeth. Over the three year period 1989 to 1991, 9888 susceptibility results from isolates examined in the SAIMR pathology laboratory were analysed and collated using a stand-alone computer program. Resistance patterns for a range of nineteen antibiotics were collated for isolates from various sampling points within the hospital. Results were reported as resistance patterns in individually isolated species. Levels of resistance in each species were compared to those reported from South Africa and abroad, and changing patterns of resistance were noted within the three year period at the Provincial Hospital, Port Elizabeth

Antimicrobial resistance patterns in a Port Elizabeth hospital

Antibiotic resistance in clinical bacterial isolates remains an ongoing problem requiring continuous monitoring to effect some form of control. Comparative studies have not been previously reported for the Eastern Cape Region, South Africa and this study was undertaken to monitor resistance patterns in clinical isolates from Provincial Hospital, Port Elizabeth. Over the three year period 1989 to 1991, 9888 susceptibility results from isolates examined in the SAIMR pathology laboratory were analysed and collated using a stand-alone computer program. Resistance patterns for a range of nineteen antibiotics were collated for isolates from various sampling points within the hospital. Results were reported as resistance patterns in individually isolated species. Levels of resistance in each species were compared to those reported from South Africa and abroad, and changing patterns of resistance were noted within the three year period at the Provincial Hospital, Port Elizabeth

Complete homochirality induced by the nonlinear autocatalysis and recycling

A nonlinear autocatalysis of a chiral substance is shown to achieve homochirality in a closed system, if the back-reaction is included. Asymmetry in the concentration of two enantiomers or the enantiometric excess increases due to the nonlinear autocatalysis. Furthermore, when the back-reaction is taken into account, the reactant supplied by the decomposition of the enantiomers is recycled to produce more and more the dominant one, and eventually the homochirality is established.Comment: 4 pages, 2 figure

The Large, Oxygen-Rich Halos of Star-Forming Galaxies Are A Major Reservoir of Galactic Metals

The circumgalactic medium (CGM) is fed by galaxy outflows and accretion of intergalactic gas, but its mass, heavy element enrichment, and relation to galaxy properties are poorly constrained by observations. In a survey of the outskirts of 42 galaxies with the Cosmic Origins Spectrograph onboard the Hubble Space Telescope, we detected ubiquitous, large (150 kiloparsec) halos of ionized oxygen surrounding star-forming galaxies, but we find much less ionized oxygen around galaxies with little or no star formation. This ionized CGM contains a substantial mass of heavy elements and gas, perhaps far exceeding the reservoirs of gas in the galaxies themselves. It is a basic component of nearly all star-forming galaxies that is removed or transformed during the quenching of star formation and the transition to passive evolution.Comment: This paper is part of a set of three papers on circumgalactic gas observed with the Cosmic Origins Spectrograph on HST, to be published in Science, together with related papers by Tripp et al. and Lehner & Howk, in the November 18, 2011 edition. This version has not undergone final copyediting. Please see Science online for the final printed versio

The COS Absorption Survey of Baryon Harbors (CASBaH): Warm-hot Circumgalactic Gas Reservoirs Traced by Ne VIII Absorption

We survey the highly ionized circumgalactic media (CGM) of 29 blindly selected galaxies at 0.49 < z_(gal) < 1.44 based on high-S/N ultraviolet spectra of z > 1 QSOs and the galaxy database from the COS Absorption Survey of Baryon Harbors (CASBaH). We detect the Ne VIII doublet in nine of the galaxies, and for gas with N(Ne VIII) > 10^13.3 cm^-2 (> 10^13.5 cm^-2), we derive a Ne VIII covering fraction f_c = 75 +15/-25% (44 +22/-20%) within impact parameter (rho) < 200 kpc of M_* = 10^(9.5-11.5) Msol galaxies and f_c = 70 +16/-22% (f_c = 42 +20/-17%) within rho < 1.5 virial radii. We estimate the mass in Ne VIII-traced gas to be M_gas(Ne VIII) > 10^9.5 Msol (Z/Zsol)^-1, or 6-20% of the expected baryonic mass if the Ne VIII absorbers have solar metallicity. Ionizing Ne VII to Ne VIII requires 207 eV, and photons with this energy are scarce in the CGM. However, for the median halo mass and redshift of our sample, the virial temperature is close to the peak temperature for the Ne VIII ion, and the Ne VIII-bearing gas is plausibly collisionally ionized near this temperature. Moreover, we find that photoionized Ne VIII requires cool and low-density clouds that would be highly underpressured (by approximately two orders of magnitude) relative to the putative, ambient virialized medium, complicating scenarios where such clouds could survive. Thus, more complex (e.g., non-equilibrium) models may be required; this first statistical sample of Ne VIII absorber/galaxy systems will provide stringent constraints for future CGM studies.Comment: Published in ApJL, Volume 877, Issue 2, Article L2

The Role of Sub-damped Lyman-alpha Absorbers in the Cosmic Evolution of Metals

Observations of low mean metallicity of damped Lyman-alpha (DLA) quasar absorbers at all redshifts studied appear to contradict the predictions for the global mean interstellar metallicity in galaxies from cosmic chemical evolution models. On the other hand, a number of metal-rich sub-DLA systems have been identified recently, and the fraction of metal-rich sub-DLAs appears to be considerably larger than that of metal-rich DLAs, especially at z < 1.5. In view of this, here we investigate the evolution of metallicity in sub-DLAs. We find that the mean Zn metallicity of the observed sub-DLAs may be higher than that of the observed DLAs, especially at low redshifts, reaching a near-solar level at z <~ 1. This trend does not appear to be an artifact of sample selection, the use of Zn, the use of N_{HI}-weighting, or observational sensitivity. While a bias against very low metallicity could be present in the sub-DLA sample in some situations, this cannot explain the difference between the DLA and sub-DLA metallicities at low z. The primary reason for the difference between the DLAs and sub-DLAs appears to be the dearth of metal-rich DLAs. We estimate the sub-DLA contribution to the total metal budget using measures of their metallicity and comoving gas density. These calculations suggest that at z <~ 1, the contribution of sub-DLAs to the total metal budget may be several times that of DLAs. At higher redshifts also, there are indications that the sub-DLAs may contribute significantly to the cosmic metal budget.Comment: 9 pages, 2 figures, Accepted for Publication in the Astrophysical Journa

Book Reviews

Die hartJou Harl en Lewe. Deur A. J. Brink. Bl. 248. Gemustreer. RI6,95. Pretoria: Femina. 1982.The physiology of digestionExperiments and Observations on the Gastric Juice and the Physiology of Digestion. By William Beaumonr. 1st ed. 1&amp;33. Reprinted in facsimile for the Classics ofMedicine Library, Division of Gryphon Editions Ltd, Birmingham, Alabama, 1980.Bone in Clinical Orthopaedics: A Study in ComparativeOsteology. Ed. by G. Sumner-Smith. Pp. xvi + 435. Illustrated. R94,25. Philadelphia: W. B. Saunders. 1982.Tamoxifen in breast cancerThe Role of Tamoxifen in Breast Cancer. Ed. by S. Iacobelli, M. E. Lippman and G. R. Della Cuna. Pp. xii + 124. Illustrated. 523,12. New York: Raven Press. 1982.Under the Influence. A History ofNitrous Oxide and OxygenAnaesthesia. By W. D. A. Smith. Pp. xxviii + 188. Illustrated. R33,50. London: Macmillan. 1982.Clinical internal medicine in the agedClinical Internal Medicine in the Aged. By R. W. Schrier. Pp. vii + 324. Illustrated. R61,-. Philadelphia: W. B. Saunders. 1982.Genital Infection by Chlamydia Trachomatis (Current Topicsin Infection, No. 2). By J. D. Oriel and G. L. Ridgway. Pp. viii + 144. Illustrated. R32,20. London: Edward Arnold. 1982.Placental Function Tests. By T. Chard and A. Klopper. Pp. viii + 94. Illustrated. DM42,-. Berlin: Springer-Verlag. 1982.Therapeutic Heat and Cold. 3rd ed. Ed. by J. F. Lehmann. Pp. xiv + 641. Illustrated. Baltimore: Williams &amp; Wilkins. 1982