Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson's disease: Study protocol for a randomised controlled trial

BACKGROUND: Parkinson\u27s disease (PD) results from a loss of dopamine in the brain, leading to movement dysfunctions such as bradykinesia, postural instability, resting tremor and muscle rigidity. Furthermore, dopamine deficiency in PD has been shown to result in maladaptive plasticity of the primary motor cortex (M1). Progressive resistance training (PRT) is a popular intervention in PD that improves muscular strength and results in clinically significant improvements on the Unified Parkinson\u27s Disease Rating Scale (UPDRS). In separate studies, the application of anodal transcranial direct current stimulation (a-tDCS) to the M1 has been shown to improve motor function in PD; however, the combined use of tDCS and PRT has not been investigated. METHODS/DESIGN: We propose a 6-week, double-blind randomised controlled trial combining M1 tDCS and PRT of the lower body in participants (n&thinsp;=&thinsp;42) with moderate PD (Hoehn and Yahr scale score 2-4). Supervised lower body PRT combined with functional balance tasks will be performed three times per week with concurrent a-tDCS delivered at 2 mA for 20 minutes (a-tDCS group) or with sham tDCS (sham group). Control participants will receive standard care (control group). Outcome measures will include functional strength, gait speed and variability, balance, neurophysiological function at rest and during movement execution, and the UPDRS motor subscale, measured at baseline, 3 weeks (during), 6 weeks (post), and 9 weeks (retention). Ethical approval has been granted by the Deakin University Human Research Ethics Committee (project number 2015-014), and the trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001241527). DISCUSSION: This will be the first randomised controlled trial to combine PRT and a-tDCS targeting balance and gait in people with PD. The study will elucidate the functional, clinical and neurophysiological outcomes of combined PRT and a-tDCS. It is hypothesised that combined PRT and a-tDCS will significantly improve lower limb strength, postural sway, gait speed and stride variability compared with PRT with sham tDCS. Further, we hypothesise that pre-frontal cortex activation during dual-task cognitive and gait/balance activities will be reduced, and that M1 excitability and inhibition will be augmented, following the combined PRT and a-tDCS intervention. <br /

Longitudinal rates of self-reported delinquency of at-risk and not at-risk Western Australian high school students

Two hundred and forty nine 12 to 13 year old at risk and not at risk male and female high school students randomly selected from five high schools in the Perth metropolitan area of Western Australia provided self-reported delinquency data for three consecutive years. A multivariate analysis of variance revealed at risk students self-reported significantly more involvement in delinquency at the first data collection point than their not at risk counterparts. Male 12-13 year olds self-reported significantly more involvement in car related crimes, assault, rule infractions, and vandalism compared to their female peers. For some delinquent activities there were significant increases in involvement over time (Motor Vehicle, Drugs, and Public Disorder Offences) while for others (Theft, Rule Infractions, and Vandalism) this was not the case. In the majority of categories of delinquency at risk students self-reported significantly higher rates of involvement

Age-related differences in patterns of criminal activity among a large sample of polydrug injectors in Australia

Background: The relationship between age and criminal activity among drug-using populations is poorly understood. Methods: Data from 10 years of repeat cross-sectional surveys of sentinel samples of regular people who inject drugs (PWID) across Australia (n=5844) were used to explore the relationship between age and past-month drug dealing, property crime and violent crime, and past-year arrest. Descriptive statistics were used to explore the prevalence and frequency of each outcome. The relationship between age and each outcome was measured using multivariable Poisson regression with robust error variance. Results: After adjusting for confounding factors, each 5-year increase in age was associated with significant reductions in drug dealing (adjusted incidence rate ratio [AIRR]: 0.90, 95% confidence interval [CI]: 0.87–0.94), property crime (AIRR: 0.85, 95% CI: 0.82–0.89) and violent crime (AIRR: 0.77, 95% CI: 0.70–0.85). Older participants were also significantly less likely to report being arrested in the past 12 months (AIRR: 0.91, 95% CI: 0.88–0.93). Conclusions: Younger PWID are more heavily involved in criminal activity compared with their older counterparts. This study highlights the need for early intervention programmes to prevent offending behaviour becoming entrenched, as well as continued efforts to redirect young PWID away from the criminal justice system and into treatment and education programmes

Short-chain fatty acid propionate protects from hypertensive cardiovascular damage

BACKGROUND: Arterial hypertension and its organ sequelae show characteristics of T cell mediated inflammatory diseases. Experimental anti-inflammatory therapies have been shown to ameliorate hypertensive end-organ damage. Recently, the CANTOS study targeting interleukin-1β demonstrated that anti-inflammatory therapy reduces cardiovascular risk. The gut microbiome plays pivotal role in immune homeostasis and cardiovascular health. Short-chain fatty acids (SCFA) are produced from dietary fiber by gut bacteria and affect host immune homeostasis. Here, we investigated effects of the SCFA propionate in two different mouse models of hypertensive cardiovascular damage. METHODS: To investigate the effect of SCFA on hypertensive cardiac damage and atherosclerosis, wild-type NMRI (WT) or ApoE(-/-) deficient mice received propionate (200mM) or control in the drinking water. To induce hypertension, WT mice were infused with Angiotensin (Ang)II (1.44mg/kg/d s.c.) for 14 days. To accelerate the development of atherosclerosis, ApoE(-/-) mice were infused with AngII (0.72mg/kg/d s.c.) for 28 days. Cardiac damage and atherosclerosis were assessed using histology, echocardiography, in vivo electrophysiology, immunofluorescence, and flow cytometry. Blood pressure was measured by radiotelemetry. Regulatory T cell (Treg) depletion using PC61 antibody was used to examine the mode of action of propionate. RESULTS: Propionate significantly attenuated cardiac hypertrophy, fibrosis, vascular dysfunction, and hypertension in both models. Susceptibility to cardiac ventricular arrhythmias was significantly reduced in propionate-treated AngII-infused WT mice. Aortic atherosclerotic lesion area was significantly decreased in propionate-treated ApoE(-/-). Systemic inflammation was mitigated by propionate treatment, quantified as a reduction in splenic effector memory T cell frequencies and splenic T helper 17 cells in both models, and a decrease in local cardiac immune cell infiltration in WT mice. Cardioprotective effects of propionate were abrogated in Treg-depleted AngII-infused mice, suggesting the effect is Treg-dependent. CONCLUSIONS: Our data emphasize an immune-modulatory role of SCFAs and their importance for cardiovascular health. The data suggest that lifestyle modifications leading to augmented SCFA production could be a beneficial non-pharmacological preventive strategy for patients with hypertensive cardiovascular disease

Police-initiated diversion for youth to prevent future delinquent behavior: a systematic review

BackgroundOverly punitive responses to youth misconduct may have the unintended consequence ofincreasing the likelihood of future delinquency; yet, overly lenient responses may fail to serveas a corrective for the misbehavior. Police diversion schemes are a collection of strategiespolice can apply as an alternative to court processing of youth. Police-initiated diversionschemes aim to reduce reoffending by steering youth away from deeper penetration into thecriminal justice system and by providing an alternative intervention that can help youthaddress psychosocial development or other needs that contribute to their problem behavior.ObjectivesThe objective of this review was to synthesize the evidence on the effectiveness of pre-courtinterventions involving police warning or counseling and release, and cautioning schemes inreducing delinquent behavior.Search methodsA combination of 26 databases and websites were searched. References of relevant reviewswere also scanned to identify studies. We also consulted with experts in the field. Searcheswere executed by two reviewers and conducted between August 2016 and January 2017.Selection criteriaOnly experimental and quasi-experimental designs were eligible for this review. All quasiexperimentaldesigns must have had a comparison group similar to the police diversionintervention group with respect to demographic characteristics and prior involvement indelinquent behavior (i.e., at similar risk for future delinquent behavior). Additionally, studiesmust have included youth participants between 12 and 17 years of age who either underwenttraditional system processing or were diverted from court processing through a police-leddiversion program. Studies were also eligible if delinquency-related outcomes, includingofficial and non-official (self-report or third-party reporting) measures of delinquency werereported.Data collection and analysisThis study used meta-analysis to synthesize results across studies. This method involvedsystematic coding of study features and conversion of study findings into effect sizesreflecting the direction and magnitude of any police-led diversion effect. There were 19independent evaluations across the 14 primary documents coded for this review. From this,we coded 67 effect sizes of delinquent behavior post diversion across 31 diversion-traditionalprocessing comparisons. We analyzed these comparisons using two approaches. The firstapproach selected a single effect size per comparison based on a decision rule and the secondused all 67 effect sizes, nesting these within comparison condition and evaluation design.ResultsThe general pattern of evidence is positive, suggesting that police-led diversion modestlyreduces future delinquent behavior of low-risk youth relative to traditional processing.Authors’ conclusionsThe findings from this systematic review support the use of police-led diversion for low-riskyouth with limited or no prior involvement with the juvenile justice system. Thus, policedepartments and policy-makers should consider diversionary programs as part of the mix ofsolutions for addressing youth crime

Validity of a trunk-mounted accelerometer to measure physical collisions in contact sports

© 2015 Human Kinetics, Inc. Context: Accelerometer peak impact accelerations are being used to measure player physical demands in contact sports. However, their accuracy to do so has not been ascertained. Purpose: To compare peak-impact-acceleration data from an accelerometer contained in a wearable tracking device with a 3-dimensional motion-analysis (MA) system during tackling and bumping. Methods: Twenty-five semielite rugby athletes wore a tracking device containing a 100-Hz triaxial accelerometer (MinimaxX S4, Catapult Innovations, Australia). A single retroreflective marker was attached to the device, with its position recorded by a 12-camera MA system during 3 physical-collision tasks (tackle bag, bump pad, and tackle drill; N = 625). The accuracy, effect size, agreement, precision, and relative errors for each comparison were obtained as measures of accelerometer validity. Results: Physical-collision peak impact accelerations recorded by the accelerometer overestimated (mean bias 0.60 g) those recorded by the MA system (P &lt; .01). Filtering the raw data at a 20-Hz cutoff improved the accelerometer's relationship with MA data (mean bias 0.01 g; P &gt; .05). When considering the data in 9 magnitude bands, the strongest relationship with the MA system was found in the 3.0-g or less band, and the precision of the accelerometer tended to reduce as the magnitude of impact acceleration increased. Of the 3 movements performed, the tackle-bag task displayed the greatest validity with MA. Conclusions: The findings indicate that the MinimaxX S4 accelerometer can accurately measure physical-collision peak impact accelerations when data are filtered at a 20-Hz cutoff frequency. As a result, accelerometers may be useful to measure physical collisions in contact sports

Misuse of the term ‘load’ in sport and exercise science

Despite the International System of Units (SI), as well as several publications guiding researchers on correct use of terminology, there continues to be widespread misuse of mechanical terms such as ‘work’ in sport and exercise science. A growing concern is the misuse of the term ‘load’. Terms such as ‘training load’ and ‘PlayerLoad’ are popular in sport and exercise science vernacular. However, a ‘load’ is a mechanical variable which, when used appropriately, describes a force and therefore should be accompanied with the SI-derived unit of the newton (N). It is tempting to accept popular terms and nomenclature as scientific. However, scientists are obliged to abide by the SI and must pay close attention to scientific constructs. This communication presents a critical reflection on the use of the term ‘load’ in sport and exercise science. We present ways in which the use of this term breaches principles of science and provide practical solutions for ongoing use in research and practice.</p

Misuse of the term ‘load’ in sport and exercise science

Despite the International System of Units (SI), as well as several publications guiding researchers on correct use of terminology, there continues to be widespread misuse of mechanical terms such as ‘work’ in sport and exercise science. A growing concern is the misuse of the term ‘load’. Terms such as ‘training load’ and ‘PlayerLoad’ are popular in sport and exercise science vernacular. However, a ‘load’ is a mechanical variable which, when used appropriately, describes a force and therefore should be accompanied with the SI-derived unit of the newton (N). It is tempting to accept popular terms and nomenclature as scientific. However, scientists are obliged to abide by the SI and must pay close attention to scientific constructs. This communication presents a critical reflection on the use of the term ‘load’ in sport and exercise science. We present ways in which the use of this term breaches principles of science and provide practical solutions for ongoing use in research and practice.

Validation of a Trunk-mounted Accelerometer to Measure Peak Impacts during Team Sport Movements

Copyright © 2015, Georg Thieme Verlag KG. All rights reserved. This study assessed the validity of an accelerometer to measure impacts in team sports. 76 participants completed a team sport circuit. Accelerations were collected concurrently at 100 Hz using an accelerometer and a 36-camera motion analysis system. The largest peak accelerations per movement were compared in 2 ways: i) pooled together and filtered at 13 different cut-off frequencies (range 6–25 Hz) to identify the optimal filtering frequency, and ii) the optimal cut-off frequency split into the 7 movements performed (n=532). Raw and 25–16 Hz filtering frequencies significantly overestimated and 6 Hz underestimated motion analysis peak accelerations (P &lt;0.007). The 12 Hz filtered accelerometer data revealed the strongest relationship with motion analysis data (accuracy - 0.01±0.27 g, effect size - 0.01, agreement - 0.55 to 0.53 g, precision 0.27 g, and relative error 5.5%; P=1.00). The accelerometer underestimated peak accelerations during tackling and jumping, and overestimated during walking, jogging, sprinting and change of direction. Lower agreement and reduced precision were associated with sprinting, jumping and tackling. The accelerometer demonstrated an acceptable level of concurrent validity compared to a motion analysis system when filtered at a cut-off frequency of 12 Hz. The results advocate the use of accelerometers to measure movements in team sport