Examining Self-Contained and Integrated Physical Education Experiences Among Individuals with Visual Impairments

Introduction. While research to date has examined the views of individuals with visual impairments toward integrated public-school physical education, little attention has been given to examining perspectives toward experiences at residential schools for those with visual impairments. By understanding the perspectives of those who attended physical education in both contexts, researchers can gain valuable information about particularities that can make experiences meaningful or challenging. The purpose of this study was to examine how individuals who experienced physical education in both integrated and residential school settings viewed their physical education class experiences. Methods. This study utilized a retrospective interpretative phenomenological approach (IPA) to investigate the experiences of individuals with visual impairments in two distinct physical education contexts. Five adults with visual impairments (aged 20 to 35 years; three males, two females) were enrolled in this study. Data collection for this study included semi-structured telephone interviews and reflective interview notes. Interview data were audio-recorded and transcribed verbatim, and data were analyzed thematically using a process guided by IPA. Results. Based on the data analysis, two interrelated themes emerged from the participants transcripts, (a) feelings about inclusion and exclusion, and (b) support needs met at residential schools. The first theme described participants reflections that across school settings, feelings about inclusivity and exclusivity were central to how the participants understood their physical education experiences. The second theme described how perceived teacher support and feelings of relatedness with peers were identified by the participants as important factors related to their willingness to explore the environment and engage in physical education curricula. Discussion. Across school settings, feelings about the inclusivity and exclusivity were central to how the participants understood their physical education experiences. Positive experiences in physical education, which includes engagement and success, are often influenced by supportive teacher behaviors and peer relationships (Coates & Vickerman, 2008; Haegele & Sutherland 2015). Implications for practice. The findings of this study provide teachers a depiction of experiences in two settings that can help them understand what is needed of them to provide meaningful physical education experiences for students with visual impairments

Intense Arctic Ozone Depletion in the Spring of 2011

Observations of record-breaking ozone depletion during the Arctic spring of 2011 were made at 76˚ N in Thule, Greenland. The ozone total column amount of 290 DU measured on 18 March 2011 is the lowest value from the 12-year observation record and represents an ozone depletion of up to 48% of a typical March column. The unique 2010 – 11 vortex was characterized by sustained low stratospheric temperatures and stability that resisted breakup through March. Simultaneous observations of O3, HF, HCl, HNO3, and ClONO2 demonstrate strong subsidence and substantial conversion of chlorine from its normal reservoirs.Au printemps 2011, des observations d’appauvrissement record de l’ozone ont été faites dans l’Arctique à 76˚ N à Thule, au Groenland. Le 18 mars 2011, la colonne d’ozone total a été mesurée à 290 DU, ce qui représente la valeur la plus faible depuis que les observations ont commencé à être consignées il y a 12 ans. Cela constitue un appauvrissement de l’ozone allant jusqu’à 48 % de la colonne typiquement enregistrée en mars. Le vortex unique dénoté en 2010-2011 était caractérisé par des températures stratosphériques faibles et soutenues ainsi que par une stabilité ayant résisté à la dissipation jusqu’en mars. Des observations simultanées de O3, HF, HCl, HNO3 et ClONO2 ont démontré une forte subsidence et une conversion substan­tielle du chlore à partir des réservoirs normaux

Identifying the participant characteristics that predict recruitment and retention of participants to RCTs involving children : a systematic review

Background: Randomised controlled trials (RCTs) are recommended as the gold standard in evaluating healthcare interventions. The conduct of RCTs is often impacted by difficulties surrounding recruitment and retention of participants in both adult and child populations. Factors influencing recruitment and retention of children to RCTs can be more complex than in adults. There is little synthesised evidence of what influences participation in research involving parents and children. Aim: To identify predictors of recruitment and retention in RCTs involving children. Methods/ Design: A systematic review of RCTs was conducted to synthesise the available evidence. An electronic search strategy was applied to four databases and restricted to English language publications. Quantitative studies reporting participant predictors of recruitment and retention in RCTs involving children aged 0-12 were identified. Data was extracted and synthesised narratively. Quality assessment of articles was conducted using a structured tool developed from two existing quality evaluation checklists. Results: 28 studies were included in the review. Of the 154 participant factors reported, 66 were found to be significant predictors of recruitment and retention in at least one study. These were classified as parent, child, family and neighbourhood characteristics. Parent characteristics (e.g. ethnicity, age, education, socio economic status) were the most commonly reported predictors of participation for both recruitment and retention. Being young, less educated, of an ethnic minority and low socio economic status (SES) appear to be barriers to participation in RCTs although there was little agreement between studies. When analysed according to setting and severity of the child’s illness there appeared to be little variation between groups. The quality of the studies varied. Articles adhered well to reporting guidelines around provision of a scientific rationale for the study and background information as well as displaying good internal consistency of results. However, few studies discussed the external validity of the results or provided recommendations for future research. Conclusion: Parent characteristics may predict participation of children and their families to RCTs, however, there was a lack of consensus. Whilst socio-demographics variables may be useful in identifying which groups are least likely to participate they do not provide insight into the processes and barriers to participation for children and families. Further studies that explore variables that can be influenced are warranted. Reporting of studies in this field need greater clarity as well as agreed definitions of what is meant by retention

Pilot randomized clinical trial of virtual reality pain management during adult burn dressing changes: Lessons learned.

Opioids are the most frequently used pain medications by US burn centers to control severe procedural pain during wound care. Concerns for long-term opioid use have prompted the exploration of non-pharmaceutical interventions, such as virtual reality (VR), for procedural pain management. The primary objective of this pilot study was to evaluate the feasibility and efficacy of VR pain alleviation treatment in reducing adult burn patients' perceived pain during burn dressing changes. Adult patients aged 18-70 years were recruited from the inpatient unit of a single American Burn Association-verified burn center between May 2019 and February 2020 and randomly assigned to one of three arms. Active VR participants played four VR games; passive VR participants were immersed in the same VR environment without the interaction elements; and a standard of care control group. 71 patients were screened for eligibility and 33 were deemed eligible to approach for informed consent, with 14 agreeing to participate in this study. Of these 14 patients, 4 were randomly assigned to the active VR, 4 to the passive VR, and 6 to the control group. Self-reported overall pain was lowest among participants in the active VR (dressing 1 = 41.3, dressing 2 = 61.0, and dressing 3 = 72.7) and highest among participants in the passive VR (dressing 1 = 58.3, dressing 2 = 74.5, and dressing 3 = 89.0) across all three dressing changes. Self-reported worst pain was lowest among the active VR at the first and last dressing (64.3 and 92.2, respectively), but the control group has the lowest self-reported worst pain at the second dressing (71.3). VR is a useful non-pharmacological tool for pain distraction but designing and implementing clinical research studies face many challenges in real-world medical settings. Lessons from this study have important implications for future VR studies by other researchers. Trial Registration: ClinicalTrials.gov Identifier: NCT04545229

The Vibrio parahaemolyticus Type III Secretion Systems manipulate host cell MAPK for critical steps in pathogenesis

<p>Abstract</p> <p>Background</p> <p><it>Vibrio parahaemolyticus </it>is a food-borne pathogen causing inflammation of the gastrointestinal epithelium. Pathogenic strains of this bacterium possess two Type III Secretion Systems (TTSS) that deliver effector proteins into host cells. In order to better understand human host cell responses to <it>V. parahaemolyticus</it>, the modulation of Mitogen Activated Protein Kinase (MAPK) activation in epithelial cells by an O3:K6 clinical isolate, RIMD2210633, was investigated. The importance of MAPK activation for the ability of the bacterium to be cytotoxic and to induce secretion of Interleukin-8 (IL-8) was determined.</p> <p>Results</p> <p><it>V. parahaemolyticus </it>deployed its TTSS1 to induce activation of the JNK, p38 and ERK MAPK in human epithelial cells. VP1680 was identified as the TTSS1 effector protein responsible for MAPK activation in Caco-2 cells and the activation of JNK and ERK by this protein was important in induction of host cell death. <it>V. parahaemolyticus </it>actively induced IL-8 secretion in a response mediated by TTSS1. A role for VP1680 and for the ERK signalling pathway in the stimulation of IL-8 production in epithelial cells by <it>V. parahaemolyticus </it>was established. Interestingly, TTSS2 inhibited IL-8 mRNA transcription at early stages of interaction between the bacterium and the cell.</p> <p>Conclusions</p> <p>This study demonstrated that <it>V. parahaemolyticus </it>activates the three major MAPK signalling pathways in intestinal epithelial cells in a TTSS1-dependent manner that involves the TTSS1 effector VP1680. Furthermore VP1680 and JNK and ERK activation were needed for maximal cytotoxicity of the bacterium. It was shown that <it>V. parahaemolyticus </it>is a strong inducer of IL-8 secretion and that induction reflects a balance between the effects of TTSS1 and TTSS2. Increases in IL-8 secretion were mediated by TTSS1 and VP1680, and augmented by ERK activation. These results shed light on the mechanisms of bacterial pathogenesis mediated by TTSS and suggest significant roles for MAPK signalling during infection with <it>V. parahaemolyticus</it>.</p

Spatial consistency in drivers of population dynamics of a declining migratory bird

1. Many migratory species are in decline across their geographical ranges. Single-population studies can provide important insights into drivers at a local scale, but effective conservation requires multi-population perspectives. This is challenging because relevant data are often hard to consolidate, and state-of- the-art analytical tools are typically tailored to specific datasets. 2. We capitalized on a recent data harmonization initiative (SPI-Birds) and linked it to a generalized modelling framework to identify the demographic and environmental drivers of large-scale population decline in migratory pied flycatchers (Ficedula hypoleuca) breeding across Britain. 3. We implemented a generalized integrated population model (IPM) to estimate age-specific vital rates, including their dependency on environmental conditions, and total and breeding population size of pied flycatchers using long-term (34–64 years) monitoring data from seven locations representative of the British breeding range. We then quantified the relative contributions of different vital rates and population structure to changes in short-and long-term population growth rate using transient life table response experiments (LTREs). 4. Substantial covariation in population sizes across breeding locations suggested that change was the result of large-scale drivers. This was supported by LTRE analyses, which attributed past changes in short-term population growth rates and long-term population trends primarily to variation in annual survival and dispersal dynamics, which largely act during migration and/or nonbreeding season. Contributions of variation in local reproductive parameters were small in comparison, despite sensitivity to local temperature and rainfall within the breeding period. 5. We show that both short-and long-term population changes of British breeding pied flycatchers are likely linked to factors acting during migration and in nonbreeding areas, where future research should be prioritized. We illustrate the potential of multi-population analyses for informing management at (inter)national scales and highlight the importance of data standardization, generalized and accessible analytical tools, and reproducible workflows to achieve them. annual survival, comparative analysis, environmental effects, full annual cycle, integrated population model, LTRE, multi-population, pied flycatcherpublishedVersio

The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review

Purpose Multiple Sclerosis (MS) is a highly variable condition characterised by uncertainty of disease course which can make formation of expectations about the future difficult. This systematic review aimed to examine associations between expectations, or Future Oriented Cognitions (FOCs), and Quality of Life (QOL) in people with MS (PwMS). Methods Following PRISMA guidelines, literature up to October 2019 was searched using Medline, EMBASE, PsycINFO and Web of Science. Quantitative studies that investigated relationships between FOCs and QOL in PwMS (assessed using a standardised QOL assessment) were considered for inclusion. After data extraction, results were analysed using narrative synthesis, focusing on the valence of FOCs (positive, negative, unvalenced). Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). All stages of the review were patient-led by a person with MS. Results A total of 13 studies met the review inclusion criteria, with a combined sample size of 4,179. Of these studies, 11 involved measures of positive FOCs, most commonly self-efficacy, one measured a negative FOC, with one FOC unclassified. Nine studies found significant associations between QOL and self-efficacy. Although other positively valenced constructs were less frequently reported, significant associations with higher QOL were also evidenced. Conclusions Identifying ways to foster positive FOCs, particularly self-efficacy, may have beneficial effects on QOL. More research is needed to understand the impacts of negative FOCs on QOL to determine whether these processes could be meaningfully targeted in interventions

Validation of a Model for Identification of Patients With Compensated Cirrhosis at High Risk of Decompensation

Background & Aims: It is important to rapidly identify patients with advanced liver disease. Routine tests to assess liver function and fibrosis provide data that can be used to determine patients’ prognoses. We tested the validated the ability of combined data from the ALBI and FIB-4 scoring systems to identify patients with compensated cirrhosis at highest risk for decompensation.Methods: We collected data from 145 patients with compensated cirrhosis (91% Child A cirrhosis and median MELD scores below 8) from a cohort in Nottingham, United Kingdom, followed for a median 4.59 years (development cohort). We collected baseline clinical features and recorded decompensation events. We used these data to develop a model based on liver function (assessed by the ALBI score) and extent of fibrosis (assessed by the FIB-4 index) to determine risk of decompensation. We validated the model in 2 independent external cohorts (1 in Dublin, Ireland and 1 in Menoufia, Egypt) comprising 234 patients.Results: In the development cohort, 19.3% of the patients developed decompensated cirrhosis. Using a combination of ALBI and FIB-4 scores, we developed a model that identified patients at low vs high risk of decompensation (hazard ratio [HR] for decompensation in patients with high risk score was 7.10). When we tested the scoring system in the validation cohorts, the HR for decompensation in patients with a high-risk score was 12.54 in the Ireland cohort and 5.10 in the Egypt cohort.Conclusion: We developed scoring system, based on a combination of ALBI and FIB-4 scores, that identifies patients at risk for liver decompensation. We validated the scoring system in 2 independent international cohorts (Europe and the Middle East), so it appears to apply to diverse populations

Protein kinase A negatively regulates Ca2+ signalling in Toxoplasma gondii

The phylum Apicomplexa comprises a group of obligate intracellular parasites that alternate between intracellular replicating stages and actively motile extracellular forms that move through tissue. Parasite cytosolic Ca2+ signalling activates motility, but how this is switched off after invasion is complete to allow for replication to begin is not understood. Here, we show that the cyclic adenosine monophosphate (cAMP)-dependent protein kinase A catalytic subunit 1 (PKAc1) of Toxoplasma is responsible for suppression of Ca2+ signalling upon host cell invasion. We demonstrate that PKAc1 is sequestered to the parasite periphery by dual acylation of PKA regulatory subunit 1 (PKAr1). Upon genetic depletion of PKAc1 we show that newly invaded parasites exit host cells shortly thereafter, in a perforin-like protein 1 (PLP-1)-dependent fashion. Furthermore, we demonstrate that loss of PKAc1 prevents rapid down-regulation of cytosolic [Ca2+] levels shortly after invasion. We also provide evidence that loss of PKAc1 sensitises parasites to cyclic GMP (cGMP)-induced Ca2+ signalling, thus demonstrating a functional link between cAMP and these other signalling modalities. Together, this work provides a new paradigm in understanding how Toxoplasma and related apicomplexan parasites regulate infectivity