Exercise interventions for adults and children with cerebral palsy (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: - The primary aim of this systematic review is to evaluate the effect of exercise interventions on activity, participation, and health-related quality of life (HRQoL) in adults and children with CP. - The secondary aim is to evaluate the effect of exercise interventions on body functions and body structures.Jennifer M Ryan is receiving funding from Action Medical Research and the Chartered Society of Physiotherapy Charitable Trust to evaluate the feasibility, acceptability, and efficacy of resistance training in adolescents with cerebral palsy

Waist circumference provides an indication of numerous cardiometabolic risk factors in adults with cerebral palsy

This article has been made available through the Brunel Open Access Publishing Fund.Objective: To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors. Design: Cross-sectional study. Setting: Testing took place in a laboratory setting. Participants: Adults with CP (NZ55; mean age, 37.5 13.3y; Gross Motor Function Classification System levels, IeV) participated in this study. Interventions: Not applicable. Main Outcome Measures: Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement. Results: The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (bZ.451; P<.01). WC was associated with HOMA-IR (bZ.480; P<.01), triglycerides (bZ.450; P<.01), and systolic blood pressure (bZ.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713e.763). Conclusions: A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP

Defining the content and delivery of an intervention to Change AdhereNce to treatment in BonchiEctasis (CAN-BE): a qualitative approach incorporating the Theoretical Domains Framework, behavioural change techniques and stakeholder expert panels

BACKGROUND: Low patient adherence to treatment is associated with poorer health outcomes in bronchiectasis. We sought to use the Theoretical Domains Framework (TDF) (a framework derived from 33 psychological theories) and behavioural change techniques (BCTs) to define the content of an intervention to change patients' adherence in bronchiectasis (Stage 1 and 2) and stakeholder expert panels to define its delivery (Stage 3). METHODS: We conducted semi-structured interviews with patients with bronchiectasis about barriers and motivators to adherence to treatment and focus groups or interviews with bronchiectasis healthcare professionals (HCPs) about their ability to change patients' adherence to treatment. We coded these data to the 12 domain TDF to identify relevant domains for patients and HCPs (Stage 1). Three researchers independently mapped relevant domains for patients and HCPs to a list of 35 BCTs to identify two lists (patient and HCP) of potential BCTs for inclusion (Stage 2). We presented these lists to three expert panels (two with patients and one with HCPs/academics from across the UK). We asked panels who the intervention should target, who should deliver it, at what intensity, in what format and setting, and using which outcome measures (Stage 3). RESULTS: Eight TDF domains were perceived to influence patients' and HCPs' behaviours: Knowledge, Skills, Beliefs about capability, Beliefs about consequences, Motivation, Social influences, Behavioural regulation and Nature of behaviours (Stage 1). Twelve BCTs common to patients and HCPs were included in the intervention: Monitoring, Self-monitoring, Feedback, Action planning, Problem solving, Persuasive communication, Goal/target specified:behaviour/outcome, Information regarding behaviour/outcome, Role play, Social support and Cognitive restructuring (Stage 2). Participants thought that an individualised combination of these BCTs should be delivered to all patients, by a member of staff, over several one-to-one and/or group visits in secondary care. Efficacy should be measured using pulmonary exacerbations, hospital admissions and quality of life (Stage 3). CONCLUSIONS: Twelve BCTs form the intervention content. An individualised selection from these 12 BCTs will be delivered to all patients over several face-to-face visits in secondary care. Future research should focus on developing physical materials to aid delivery of the intervention prior to feasibility and pilot testing. If effective, this intervention may improve adherence and health outcomes for those with bronchiectasis in the future

Chronic conditions in adults with cerebral palsy

Adults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP;2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP

Charities’ use of Twitter : exploring social support for women living with and beyond breast cancer

Twitter is one social media platform that enables those experiencing breast cancer to access support from others. This study explores how cancer charities provide support to women living with and beyond breast cancer (LWBBC) through their Twitter feeds. Seven hundred and seventy-two tweets from seven purposively sampled cancer charities were used to explore Twitter posts made relating to social support. Two questions were posed: (1) what type of support is positioned by cancer charities on Twitter for women LWBBC and (2) what themes emerge from tweet content pertaining to support for women LWBBC? Using a peer-reviewed typology of ‘social support’ [Rui, J., Chen, Y., & Damiano, A. (2013). Health organizations providing and seeking social support: A twitter-based content analysis. Cyberpsychology, Behavior, And Social Networking, 16(9), 669–673. doi:10.1089/cyber.2012.0350], a deductive content analysis was utilised to identify informational, instrumental or emotional social support tweets (n = 199). Over half (56%) of tweets offered informational support; 27% provided or sought instrumental support and 18% related to emotional support. Interestingly, 74.3% (n = 573) of tweets were not related to providing or seeking social support. An inductive qualitative thematic analysis of the 199 tweets identified the focus (i.e., themes) of support. Three themes were identified: (1) raising awareness, (2) focusing on the future and (3) sharing stories. Cancer charities predominantly use Twitter to signpost women to informational resources and to seek instrumental support to meet charitable objectives. As the number of women LWBBC continues to increase, this study provides valuable insight into how charities represent themselves on Twitter in relation to the social support needs of women LWBBC

On the combination of high-pressure and low-pressure exhaust gas recirculation loops for improved fuel economy and reduced emissions in high-speed direct-injection engines

In this paper, an experimental study of the combination of low-pressure and high-pressure exhaust gas recirculation architectures has been carried out. In the first part of the paper, the effects of both high-pressure and low-pressure exhaust gas recirculation architectures on engine behaviour and performance are analysed by means of a series of steady tests. In the second part, the effects of the combination of both architectures are addressed. The results show that the low-pressure configuration improves high-pressure exhaust gas recirculation results in brake-specific fuel consumption, nitrogen oxides and exhaust gas opacity; nevertheless, hydrocarbon emissions are increased, especially during the engine warm up. In addition, the exhaust gas recirculation rate achieved with low-pressure systems is limited by the pressure difference between diesel particulate matter outlet and compressor inlet; therefore, the high-pressure system can be used to achieve the required exhaust gas recirculation levels without increasing pumping losses. In this sense, the combination of both exhaust gas recirculation layouts offers significant advantages to reduce emissions and fuel consumption to meet future emission requirements.This work was supported by the Ministry of Science and Innovation (Spanish Government) [grant number IPT-370000-2010-022].Desantes Fernández, JM.; Luján, JM.; Plá Moreno, B.; Soler Muniesa, JA. (2013). On the combination of high-pressure and low-pressure exhaust gas recirculation loops for improved fuel economy and reduced emissions in high-speed direct-injection engines. International Journal of Engine Research. 14(1):3-11. https://doi.org/10.1177/1468087412437623S311141Taylor, A. M. K. P. (2008). Science review of internal combustion engines. Energy Policy, 36(12), 4657-4667. doi:10.1016/j.enpol.2008.09.001Lü, X.-C., Chen, W., & Huang, Z. (2005). A fundamental study on the control of the HCCI combustion and emissions by fuel design concept combined with controllable EGR. Part 2. Effect of operating conditions and EGR on HCCI combustion. Fuel, 84(9), 1084-1092. doi:10.1016/j.fuel.2004.12.015Nakano, M., Mandokoro, Y., Kubo, S., & Yamazaki, S. (2000). Effects of exhaust gas recirculation in homogeneous charge compression ignition engines. International Journal of Engine Research, 1(3), 269-279. doi:10.1243/1468087001545173Zheng, M., Reader, G. T., & Hawley, J. G. (2004). Diesel engine exhaust gas recirculation––a review on advanced and novel concepts. Energy Conversion and Management, 45(6), 883-900. doi:10.1016/s0196-8904(03)00194-8Hountalas, D. T., Mavropoulos, G. C., & Binder, K. B. (2008). Effect of exhaust gas recirculation (EGR) temperature for various EGR rates on heavy duty DI diesel engine performance and emissions. Energy, 33(2), 272-283. doi:10.1016/j.energy.2007.07.002Luján, J. M., Galindo, J., Serrano, J. R., & Pla, B. (2008). A methodology to identify the intake charge cylinder-to-cylinder distribution in turbocharged direct injection Diesel engines. Measurement Science and Technology, 19(6), 065401. doi:10.1088/0957-0233/19/6/065401Ladommatos, N., Abdelhalim, S., & Zhao, H. (2000). The effects of exhaust gas recirculation on diesel combustion and emissions. International Journal of Engine Research, 1(1), 107-126. doi:10.1243/1468087001545290Maiboom, A., Tauzia, X., & Hétet, J.-F. (2008). Influence of high rates of supplemental cooled EGR on NOxand PM emissions of an automotive HSDI diesel engine using an LP EGR loop. International Journal of Energy Research, 32(15), 1383-1398. doi:10.1002/er.1455Gautier, P., Albrecht, A., Chasse, A., Moulin, P., Pagot, A., Fontvieille, L., & Issartel, D. (2009). A Simulation Study of the Impact of LP EGR on a Two-Stage Turbocharged Diesel Engine. Oil & Gas Science and Technology - Revue de l’IFP, 64(3), 361-379. doi:10.2516/ogst/2009019Torregrosa, A. J., Olmeda, P., Martín, J., & Degraeuwe, B. (2006). Experiments on the influence of inlet charge and coolant temperature on performance and emissions of a DI Diesel engine. Experimental Thermal and Fluid Science, 30(7), 633-641. doi:10.1016/j.expthermflusci.2006.01.00

THE DISTRIBUTION AND SPREAD OF ALIEN VASCULAR PLANTS ON PRINCE EDWARD ISLAND

Surveys of alien plants at subantarctic Prince Edward Island in 2001 show that the ranges of all three introduced species have increased since the last survey in 1998. Poa annua, the longest-established species, increased its range substantially after 1987, prior to which it was confined to a single site for more than 20 years. It remains largely restricted to sites characterized by intense disturbance by seals and seabirds. Sagina procumbens, the most recently discovered alien plant, has spread even more rapidly (up to 800 m year-1) and has colonized the west coast of the island (a leap of at least 3 km). Unlike Poa annua, it is not restricted to animal-disturbed areas, although its seeds probably are dispersed by both birds and fur seals. Cerastium fontanum also continues to spread at the island, but remains confined to the western coastal plain, where it occurs mostly on dry feldmark slopes or erosion scars. All three species have expanded their ranges faster than at Marion Island, possibly because of a warmer recent climate and higher densities of seabirds and seals at Prince Edward Island. The ranges of alien plants are likely to continue to expand, with S. procumbens causing considerable changes in the island\'s terrestrial ecology.Afr. J. mar. Sci. 25: 555–56

Neutron powder diffraction determination of the magnetic structure of Nd2Al

We have determined the magnetic structure of Nd 2 Al by neutron powder diffraction. This orthorhombic intermetallic compound orders ferromagnetically below 36 K with the Nd moments aligned along the b-axis. Even at 1.7 K, the larger of the two Nd moments is only 2.3(2) μ B , about 70% of the 'free-ion' value of 3.27 μ B . This reduction is a consequence of the substantial crystal-field effects at the Nd 3+ sites.(c) 2011 IOP Publishing LT

Variability in the type and layer distribution of cortical A beta pathology in familial Alzheimer's disease

Familial Alzheimer's disease (FAD) is caused by autosomal dominant mutations in the PSEN1, PSEN2 or APP genes, giving rise to considerable clinical and pathological heterogeneity in FAD. Here we investigate variability in clinical data and the type and distribution of Aβ pathologies throughout the cortical layers of different FAD mutation cases. Brain tissue from 20 FAD cases [PSEN1 pre-codon 200 (n = 10), PSEN1 post-codon 200 (n = 6), APP (n = 4)] were investigated. Frontal cortex sections were stained immunohistochemically for Aβ, and Nissl to define the cortical layers. The frequency of different amyloid-beta plaque types was graded for each cortical layer and the severity of cerebral amyloid angiopathy (CAA) was determined in cortical and leptomeningeal blood vessels. Comparisons were made between FAD mutations and APOE4 status, with associations between pathology, clinical and genetic data investigated. In this cohort, possession of an APOE4 allele was associated with increased disease duration but not with age at onset, after adjusting for mutation sub-group and sex. We found Aβ pathology to be heterogeneous between cases although Aβ load was highest in cortical layer 3 for all mutation groups and a higher Aβ load was associated with APOE4. The PSEN1 post-codon 200 group had a higher Aβ load in lower cortical layers, with a small number of this group having increased cotton wool plaque pathology in lower layers. Cotton wool plaque frequency was positively associated with the severity of CAA in the whole cohort and in the PSEN1 post-codon 200 group. Carriers of the same PSEN1 mutation can have differing patterns of Aβ deposition, potentially because of differences in risk factors. Our results highlight possible influences of APOE4 genotype, and PSEN1 mutation type on Aβ deposition, which may have effects on the clinical heterogeneity of FAD