ONTIME Self-Initiated Mobility

The project took place at Vanderbilt\u27s Pediatric Rehabilitation, specifically in their pediatric seating and mobility clinic. The focus of the project was the Explorer Mini which is the first exploratory device for infants 12-36 months old. The research team created an literature-based introductory protocol on how to introduce the device to the child. My section specifically focused on the preparatory stage which is the very first stage and when the child explores the device before being put in it. I also created numerous handouts for the seating and mobility clinic along with reference cards for how to use the Explorer Mini based off the user\u27s manual. Finally, I arranged for the device to be delivered and an in-service was given by Permobil for therapists at the clinic on the purpose of the device, how it functions, and how it should be used

The Effect of Dietary Supplements of w3 Polyunsaturated Fatty Acids on the Fatty Acid Composition of Platelets and Plasma Choline Phosphoglycerides

Although it is not known iflinolenic acid (18:3w3) is essential its derivatives are important (Tinoco et a/. 1979). Eicosapentaenoic acid (20:5w3) is the precursor of the triene prostaglandins (Gryglewski et a/. 1979) and when incorporated into platelet lipids may influence bleeding time (Sanders et al. 1980). Docosahexaenoic acid (22:0013) is a major component of human brain and retinal lipids and is found in its highest concentrations in the phosphoglycerides of synaptic membranes and rod outer segments implying that it has a role in neural transmission. Radiotracer experiments in vitro suggest that man can convert 18:3w3 to 20:5w3 and 22:0013 (De Gomez Dumm & Brenner, 1975; Aerberhard et al. 1978) but this capacity may be limited (Dyerberg et a/. 1980). Consequently dietary 20: 5w3 and 22: 0013 may be important (Crawford & Sinclair, 1972), the only significant sources being fish, fish oil and offal (Shepherd et al. 1978; Southgate & Paul, 1978). Indeed, vegans whose diets are devoid of 20:5w3 and 22:0013 have very much lower proportions of these fatty acids in their plasma choline phosphoglycerides than do omnivores (Sanders eta/. 1977). It was suggested that the high value for the ratio, 18:2w6:18:3w3 in the vegan diets suppressed the transformation of 18:3w3 to 20: 5w3 and 22:6w3 and instead favoured the conversion of 18:2w6 to 20:4w6 and 22:4w6. This being so then a dietary supplement of 18: 3w3 should reduce the value for 18:2w6:18:3w3 and lead to an increase in the proportions of 20:5w3 and 22:0013 in this lipid fraction. In order to test this hypothesis, vegan and omnivore subjects were given a supplement of linseed oil, rich in 18:3w3 for 2 weeks and changes in their blood lipids were monitored. So that a comparison could be made between dietary linolenate and its long-chain derivatives, the effect of a fish oil supplement, rich in 20:5w3 and 22: 0013, was also studied in the omnivores

Erythrocytes in multiple sclerosis: forgotten contributors to the pathophysiology?

Multiple sclerosis (MS) is an autoimmune disease characterised by lymphocytic infiltration of the central nervous system and subsequent destruction of myelin and axons. On the background of a genetic predisposition to autoimmunity, environmental triggers are assumed to initiate the disease. The majority of MS research has focused on the pathological involvement of lymphocytes and other immune cells, yet a paucity of attention has been given to erythrocytes, which may play an important role in MS pathology. The following review briefly summarises how erythrocytes may contribute to MS pathology through impaired antioxidant capacity and altered haemorheological features. The effect of disease-modifying therapies on erythrocytes is also reviewed. It may be important to further investigate erythrocytes in MS, as this could broaden the understanding of the pathological mechanisms of the disease, as well as potentially lead to the discovery of novel and innovative targets for future therapies

Systematic Review and Meta-Analysis of Cardiovascular Consequences of Myocardial Bridging in Hypertrophic Cardiomyopathy

Myocardial bridging (MB) is a congenital variant in which a segment of a coronary artery follows an atypical intramural course under a “bridge” of myocardium and is notably common in hypertrophic cardiomyopathy (HCM). This systematic review and meta-analysis explored the clinical consequences of MB in patients with HCM. A total of 3 outcome domains were investigated: cardiovascular mortality, nonfatal adverse cardiac events, and investigative indicators of myocardial ischemia. A meta-analysis was performed on 10 observational studies comparing outcomes in patients with HCM with and without MB. Studies were identified through a systematic search of 4 databases (PubMed, Scopus, Medline Complete, and Web of Science). The quality of the studies was assessed using a modified version of the Downs and Black tool, from which studies could score a maximum of 23 points. The mean score was 17.5 ± 1.3 (good). The meta-analysis showed that MB was not associated with cardiovascular mortality (odds ratio [OR] 1.70, 95% confidence interval [CI] 0.56 to 5.15, p = 0.35) or nonfatal adverse cardiac events (OR 1.80, 95% CI 0.98 to 3.28, p = 0.06) but was associated with myocardial ischemia (OR 1.89, 95% CI 1.03 to 3.44, p = 0.04). In conclusion, the potential prognostic implications of MB in HCM, especially in those with hemodynamically significant bridges and/or severe underlying disease, should not be ignored. The focus of future studies should be to establish functional and morphologic thresholds, by which MB may adversely influence prognosis by corroborating imaging findings with clinical outcome data

Who Are You Going to Call? Primary Care Patients’ Disclosure Decisions Regarding Direct–to–Consumer Genetic Testing

Background: Direct–to–consumer genetic testing (DTCGT) offers risk estimates for a variety of complex diseases and conditions, yet little is known about its impact on actual users, including their decisions about sharing the information gleaned from testing. Ethical considerations include the impact of unsolicited genetic information with variable validity and clinical utility on relatives, and the possible burden to the health care system if revealed to physicians. Aims: The qualitative study explored primary care patients’ views, attitudes, and decision making considerations regarding DTCGT. This article focuses on the disclosure decisions participants made regarding participation, testing, and results of DTCGT, a topic which arose as a secondary aim of the study. Methods: Through four longitudinal interviews (pre–test, results, 3 and 12 months post–test) we examined twenty primary care patients’ decisions, expressed intentions, and actions regarding disclosure to immediate and extended family, friends and coworkers, and physicians about participation in and results of DTCGT. Individual interviews were analyzed using qualitative content analysis and a summative approach to describe the global themes. Results: Most participants disclosed to some immediate family; less than half disclosed to extended family; approximately half talked to friends. Most participants stated they would or might disclose to physicians about DTCGT and a few did. Conceptual themes that emerged from the data analysis include ambivalence about disclosure, consistency between intention and actual disclosure behavior and decisions, and conditional information sharing. Conclusions: Participants’ intentional and actual disclosure patterns offer insight into how they view DTCGT, weigh results, and the potential impact of DTCGT