The Sensewheel: An Adjunct to Wheelchair Skills Training

The purpose of this study was to investigate the influence of real time verbal feedback to optimise push arc during over ground manual wheelchair propulsion. 10 healthy non wheelchair users pushed a manual wheelchair for a distance of 25 metres on level paving, initially with no feedback and then with real time verbal feedback aimed at controlling push arc within a range of 85˚-100˚. The real time feedback was provided by a physiotherapist walking behind the wheelchair, viewing real time data on a tablet personal computer received from the Sensewheel, a lightweight instrumented wheelchair wheel. The real time verbal feedback enabled the participants to significantly increase their push arc. This increase in push arc resulted in a non-significant reduction in push rate and a significant increase in peak force application. The intervention enabled participants to complete the task at a higher mean velocity using significantly fewer pushes. This was achieved via a significant increase in the power generated during the push phase. This study identifies that a lightweight instrumented wheelchair wheel such as the Sensewheel is a useful adjunct to wheelchair skills training. Targeting the optimisation of push arc resulted in beneficial changes in propulsion technique

120 to 0 Ma tectonic evolution of the southwest Pacific and analogous geological evolution of the 600 to 220 Ma Tasman Fold Belt System

We review the tectonic evolution of the SW Pacific east of Australia from ca 120 Ma until the present. A key factor that developed early in this interval and played a major role in the subsequent geodynamic history of this region was the calving off from eastern Australia of several elongate microcontinental ribbons, including the Lord Howe Rise and Norfolk-New Caledonia Ridge. These microcontinental ribbons were isolated from Australia and from each other during a protracted extension episode from ca 120 to 52 Ma, with oceanic crust accretion occurring from 85 to 52 Ma and producing the Tasman Sea and the South Loyalty Basin. Generation of these microcontinental ribbons and intervening basins was assisted by emplacement of a major mantle plume at 100 Ma beneath the southern part of the Lord Howe Rise, which in turn contributed to rapid and efficient eastward trench rollback. A major change in Pacific plate motion at ca 55 Ma initiated east-directed subduction along the recently extinct spreading centre in the South Loyalty Basin, generating boninitic lithosphere along probably more than 1000 km of plate boundary in this region, and growth of the Loyalty-Entrecasteaux arc. Continued subduction of South Loyalty Basin crust led to the arrival at about 38 Ma of the 70-60 million years old western volcanic passive margin of the Norfolk Ridge at the trench, and west-directed emplacement of the New Caledonia ophiolite. Lowermost allochthons of this ophiolite are Maastrichtian and Paleocene rift tholeiites derived from the underthrusting passive margin. Higher allochthonous sheets include a poorly exposed boninitic lava slice, which itself was overridden by the massive ultramafic sheets that cover large parts of New Caledonia and are derived from the colliding forearc of the Loyalty-Entrecasteaux arc. Post-collisional extensional tectonism exhumed the underthrust passive margin, parts of which have blueschist and eclogite facies metamorphic assemblages. Following locking of this subduction zone at 38-34 Ma, subduction jumped eastward, to form a new west-dipping subduction zone above which formed the Vitiaz arc, that contained elements which today are located in the Tongan, Fijian, Vanuatu and Solomons arcs. Several episodes of arc splitting fragmented the Vitiaz arc and produced first the South Fiji Basin (31-25 Ma) and later (10 Ma to present) the North Fiji Basin. Collision of the Ontong Java Plateau, a large igneous province, with the Solomons section of the Vitiaz arc resulted in a reversal of subduction polarity, and growth of the Vanuatu arc on clockwise-rotating, older Vitiaz arc and South Fiji Basin crust. Continued rollback of the trench fronting the Tongan arc since 6 Ma has split this arc and produced the Lau Basin-Havre Trough. This southwest Pacific style of crustal growth above a rolling-back slab is applied to the 600-220 Ma tectonic development of the Tasman Fold Belt System in southeastern Australia, and explains key aspects of the geological evolution of eastern Australia. In particular, collision between a plume-triggered 600 Ma volcanic passive margin and a 510-515 Ma boninitic forearc of an intra-oceanic arc had the same relative orientation and geological effects as that which produced New Caledonia. A new subduction system formed probably at least several hundred kilometres east of the collision zone and produced the Macquarie arc, in which the oldest lavas were erupted ca 480 Ma. Continued slab rollback induced regional extension and the growth of narrow linear troughs in the Macquarie arc, which persisted until terminal deformation of this fold belt in the late-Middle to Late Devonian. A similar pattern of tectonic development generated the New England Fold Belt between the Late Devonian and Late Triassic. Parts of the New England Fold Belt have been broken from Australia and moved oceanward to locations in New Zealand, and on the Lord Howe Rise and Norfolk-New Caledonia Rise, during the post- 120 Ma breakup. Given that the Tasman Fold Belt System grew between 600 and 220 Ma by crustal accretion like the southwest Pacific since 120 Ma, facing the open Pacific Ocean, we question whether the eastern (Australia-Antarctica) part of the Neoproterozoic Rodinian supercontinent was joined to Laurentia

The transcription factors Egr2 and Egr3 are essential for the control of inflammation and antigen-induced proliferation of B and T cells

This article is available open access under a Creative Commons license (http://creativecommons.org/licenses/by-nc-nd/3.0/). Copyright @ 2012 Elsevier Inc.Lymphocytes provide optimal responses against pathogens with minimal inflammatory pathology. However, the intrinsic mechanisms regulating these responses are unknown. Here, we report that deletion of both transcription factors Egr2 and Egr3 in lymphocytes resulted in a lethal autoimmune syndrome with excessive serum proinflammatory cytokines but also impaired antigen receptor-induced proliferation of B and T cells. Egr2- and Egr3-defective B and T cells had hyperactive signal transducer and activator of transcription-1 (STAT1) and STAT3 while antigen receptor-induced activation of transcription factor AP-1 was severely impaired. We discovered that Egr2 and/or Egr3 directly induced expression of suppressor of cytokine signaling-1 (SOCS1) and SOCS3, inhibitors of STAT1 and STAT3, and also blocked the function of Batf, an AP-1 inhibitor, in B and T cells. Thus, Egr2 and Egr3 regulate B and T cell function in adaptive immune responses and homeostasis by promoting antigen receptor signaling and controlling inflammation.Arthritis Research U

Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

Objectives: The digitalisation of sexual and reproductive health (SRH) services offer valuable opportunities to deliver contraceptive pills and Chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and “medication-by-post” in SRH. Study design: An online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates. Results: There were 1281 participants (74% female and 49% 45 years old OR:0.43(0.23-0.81), screened for STIs less than once annually OR:0.63(0.42-0.93), concerned about confidentiality OR:0.21(0.90-0.50), concerned about absence during delivery OR:0.09(0.02-0.32), unwilling to provide blood pressure readings OR:0.22(0.04-0.97). Higher acceptability was observed among participants who reported: previously receiving medication by post OR:4.63(1.44-14.8), preference for home delivery over clinic collection OR:24.1(11.1-51.9), preference for home STI testing OR:10.3(6.16-17.4), ability to communicate with health advisors OR:4.01(1.03-15.6), and willingness to: register their real name OR:3.09(1.43-10.6), complete online health questionnaires OR:3.09(1.43-10.6), and use generic contraceptive pills OR:2.88(1.21-6.83). Conclusion: Postal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated

Beyond obesity - thermogenic adipocytes and cardiometabolic health

The global prevalence of obesity and related cardiometabolic disease continues to increase through the 21st century. Whilst multi-factorial, obesity is ultimately caused by chronic caloric excess. However, despite numerous interventions focussing on reducing caloric intake these either fail or only elicit short-term changes in body mass. There is now a focus on increasing energy expenditure instead which has stemmed from the recent ‘re-discovery’ of cold-activated brown adipose tissue (BAT) in adult humans and inducible ‘beige’ adipocytes. Through the unique mitochondrial uncoupling protein (UCP1), these thermogenic adipocytes are capable of combusting large amounts of chemical energy as heat and in animal models can prevent obesity and cardiometabolic disease. At present, human data does not point to a role for thermogenic adipocytes in regulating body weight or fat mass but points to a pivotal role in regulating metabolic health by improving insulin resistance as well as glucose and lipid homeostasis. This review will therefore focus on the metabolic benefits of BAT activation and the mechanisms and signalling pathways by which these could occur including improvements in insulin signalling in peripheral tissues, systemic lipid and cholesterol metabolism and cardiac and vascular function

Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

OBJECTIVES: The digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and 'medication-by-post' in SRH. STUDY DESIGN: An online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates. RESULTS: There were 1281 participants (74% female and 49% 45 years old (OR 0.43 (95% CI 0.23-0.81)), screened for STIs less than once annually (OR 0.63 (0.42-0.93)), concerned about confidentiality (OR 0.21 (0.90-0.50)), concerned about absence during delivery (OR 0.09 (0.02-0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04-0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44-14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1-51.9)), preference for home STI testing (OR 10.3 (6.16-17.4)), ability to communicate with health advisors (OR 4.01 (1.03-15.6)) and willingness to: register their real name (OR 3.09 (1.43-10.6)), complete online health questionnaires (OR 3.09 (1.43-10.6)) and use generic contraceptive pills (OR 2.88 (1.21-6.83)). CONCLUSIONS: Postal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated

Exposure to indoor air pollution across socio-economic groups: A review of the literature and a modelling methodology

Disparities in outdoor air pollution exposure between populations of different socio-economic status is a growing area of research, widely explored in environmental health literature. However, in developed countries, around 80% of time is spent indoors, meaning indoor air pollution may be a better proxy for personal exposure. Building characteristics and occupant behaviour mean indoor air pollution may also vary across socio-economic groups, leading to health inequalities. Following the results of a review carried out into indoor air pollution disparities, we incorporate socio-economic information into an indoor air quality model in order to evaluate exposure disparities in the indoor environment. The building physics tool EnergyPlus was used to model the effect of two policy interventions on indoor exposure to PM2.5 in two socio-economically different populations. Results suggest that households of low socio-economic status may be disproportionately affected by building and/or environmental policies which are implemented without consideration of the wider socio-economic processes governing the space

Conceptualising Primary-Secondary School Transitions:A Systematic Mapping Review of Worldviews, Theories and Frameworks

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