A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

BACKGROUND: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall.STUDY DESIGN: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments.RESULTS: Balance game training had a significant effect on levels of functional balance and balance confidence (P Peer reviewedFinal Published versio

Time for change: a new training programme for morpho-molecular pathologists?

The evolution of cellular pathology as a specialty has always been driven by technological developments and the clinical relevance of incorporating novel investigations into diagnostic practice. In recent years, the molecular characterisation of cancer has become of crucial relevance in patient treatment both for predictive testing and subclassification of certain tumours. Much of this has become possible due to the availability of next-generation sequencing technologies and the whole-genome sequencing of tumours is now being rolled out into clinical practice in England via the 100 000 Genome Project. The effective integration of cellular pathology reporting and genomic characterisation is crucial to ensure the morphological and genomic data are interpreted in the relevant context, though despite this, in many UK centres molecular testing is entirely detached from cellular pathology departments. The CM-Path initiative recognises there is a genomics knowledge and skills gap within cellular pathology that needs to be bridged through an upskilling of the current workforce and a redesign of pathology training. Bridging this gap will allow the development of an integrated 'morphomolecular pathology' specialty, which can maintain the relevance of cellular pathology at the centre of cancer patient management and allow the pathology community to continue to be a major influence in cancer discovery as well as playing a driving role in the delivery of precision medicine approaches. Here, several alternative models of pathology training, designed to address this challenge, are presented and appraised

Compressive Biomechanics of the Reptilian Intervertebral Joint

This study compared the pre-sacral intervertebral joints of the American alligator (Alligator mississippiensis) with those from specimensof Varanus. These two taxa were chosen because they have similarnumber of pre-sacral vertebrae and similar body weights; however,Varanus can move bipedally and has diarthrotic intervertebral joints,whereas Alligator has intervertebral discs and cannot move bipedally.This study consisted of three objectives: (1) to document the anatomyof the intervertebral joint, (2) to quantify the compressive biomechanicsof the intervertebral joints and explore which features contributed tocompression resistance, and (3) to quantify the impact of compressionon the intervertebral foramen and spinal nerves in these two taxa. Theexperimental results revealed that the diarthrotic intervertebral jointsof Varanus were significantly (4x) stiffer than the intervertebral disc ofAlligator, and that a significant component of this increased stiffnessarose from the facet joints. Compressing the intervertebral joints of thetwo taxa caused a reduction in foraminal area, but the magnitude of thisreduction was not significantly different. We hypothesize that the mainfactor preventing spinal nerve impingement in Varanus during gravitational compression is the relatively small size of the spinal ganglion/nerve relative to the foraminal area

Text messaging to help women with overweight or obesity lose weight after childbirth:the intervention adaptation and SMS feasibility RCT

Background There is a need to develop weight management interventions that fit seamlessly into the busy lives of women during the postpartum period. Objective The objective was to develop and pilot-test an evidence- and theory-based intervention, delivered by short message service, which supported weight loss and weight loss maintenance in the postpartum period. Design Stage 1 involved the development of a library of short message service messages to support weight loss and weight loss maintenance, with personal and public involvement, focusing on diet and physical activity with embedded behaviour change techniques, and the programming of a short message service platform to allow fully automated intervention delivery. Stage 2 comprised a 12-month, single-centre, two-arm, pilot, randomised controlled trial with an active control. Setting This study was set in Northern Ireland; women were recruited via community-based approaches. Participants A total of 100 women with overweight or obesity who had given birth in the previous 24 months were recruited. Interventions The intervention group received an automated short message service intervention about weight loss and weight loss maintenance for 12 months. The active control group received automated short message service messages about child health and development for 12 months. Main outcome measures The main outcomes measured were the feasibility of recruitment and retention, acceptability of the intervention and trial procedures, and evidence of positive indicative effects on weight. Weight, waist circumference and blood pressure were measured by the researchers; participants completed a questionnaire booklet and wore a sealed pedometer for 7 days at baseline, 3, 6, 9 and 12 months. Outcome assessments were collected during home visits and women received a voucher on completion of each of the assessments. Qualitative interviews were conducted with women at 3 and 12 months, to gather feedback on the intervention and active control and the study procedures. Quantitative and qualitative data were used to inform the process evaluation and to assess fidelity, acceptability, dose, reach, recruitment, retention, contamination and context. Results The recruitment target of 100 participants was achieved (intervention, n = 51; control, n = 49); the mean age was 32.5 years (standard deviation 4.3 years); 28 (28%) participants had a household income o

Comparison of general population, patient, and carer utility values for dementia health states.

Utility values to estimate quality-adjusted life years (QALYs) for use in cost-utility analyses are usually elicited from members of the general population. Public attitudes and understanding of dementia in particular may mean that values elicited from the general population may differ from patients and carers for dementia health states. This study examines how the population impacts utility values elicited for dementia health states using interviewer-administered time tradeoff valuation of health states defined by the dementia-specific preference-based measures DEMQOL-U (patient-report) and DEMQOL-Proxy-U (carer-report). Eight DEMQOL-U states were valued by 78 members of the UK general population and 71 patients with dementia of mild severity. Eight DEMQOL-Proxy-U states were valued by 77 members of the UK general population and 71 carers of patients with dementia of mild severity. Random-effects generalized least squares regression estimated the impact of population, dementia health state, and respondent sociodemographic characteristics on elicited values, finding that values for dementia health states differed by population and that the difference varied across dementia health states. Patients with dementia and carers of patients with dementia gave systematically lower values than members of the general population that were not due to differences in the sociodemographic characteristics of the populations. Our results suggest that the population used to produce dementia health state values could impact the results of cost-utility analyses and potentially affect resource allocation decisions; yet, currently, only general population values are available for usage

A Protein Scaffold Coordinates SRC-Mediated JNK Activation in Response to Metabolic Stress

Obesity is a major risk factor for the development of metabolic syndrome and type 2 diabetes. How obesity contributes to metabolic syndrome is unclear. Free fatty acid (FFA) activation of a non-receptor tyrosine kinase (SRC)-dependent cJun NH2-terminal kinase (JNK) signaling pathway is implicated in this process. However, the mechanism that mediates SRC-dependent JNK activation is unclear. Here, we identify a role for the scaffold protein JIP1 in SRC-dependent JNK activation. SRC phosphorylation of JIP1 creates phosphotyrosine interaction motifs that bind the SH2 domains of SRC and the guanine nucleotide exchange factor VAV. These interactions are required for SRC-induced activation of VAV and the subsequent engagement of a JIP1-tethered JNK signaling module. The JIP1 scaffold protein, therefore, plays a dual role in FFA signaling by coordinating upstream SRC functions together with downstream effector signaling by the JNK pathway

When does the action start and finish? Making the case for an ethnographic action research in educational research

This paper explores how ethnographic and action research methodologies can be justifiably combined to create a new methodological approach in educational research. It draws on existing examples in both educational research and development studies that have discussed the use of ethnography and action research in specific projects. Interpretations of ethnography and action research are developed that aim to minimise the epistemological differences between them. The paper also contextualises an ‘ethnographic action research’ approach with reference to an example of the author’s research into participation in three ‘reception’ (first year of schooling) classes in the United Kingdom. It is argued that research into the theme of participation in early years education, using participative methods, was particularly suitable for this new methodological approach

The Lantern Vol. 19, No. 1, Winter 1951

• Nevin LaRue • There Stands a Wall • An Iron God • Little Reginald and the Goat Tale • The Atom After Dark • Lament • To • Tell Me • Eight-Fifteen • After Reading Robert Frost • New Era • Eternity • Recollection • Two Poemshttps://digitalcommons.ursinus.edu/lantern/1052/thumbnail.jp

Glucose-6-phosphate dehydrogenase-derived NADPH fuels superoxide production in the failing heart.

In the failing heart, NADPH oxidase and uncoupled NO synthase utilize cytosolic NADPH to form superoxide. NADPH is supplied principally by the pentose phosphate pathway, whose rate-limiting enzyme is glucose 6-phosphate dehydrogenase (G6PD). Therefore, we hypothesized that cardiac G6PD activation drives part of the excessive superoxide production implicated in the pathogenesis of heart failure. Pacing-induced heart failure was performed in eight chronically instrumented dogs. Seven normal dogs served as control. End-stage failure occurred after 28 +/- 1 days of pacing, when left ventricular end-diastolic pressure reached 25 mm Hg. In left ventricular tissue homogenates, spontaneous superoxide generation measured by lucigenin (5 microM) chemiluminescence was markedly increased in heart failure (1338 +/- 419 vs. 419 +/- 102 AU/mg protein, P < 0.05), as were NADPH levels (15.4 +/- 1.5 vs. 7.5 +/- 1.5 micromol/gww, P < 0.05). Superoxide production was further stimulated by the addition of NADPH. The NADPH oxidase inhibitor gp91(ds-tat) (50 microM) and the NO synthase inhibitor L-NAME (1 mM) both significantly lowered superoxide generation in failing heart homogenates by 80% and 76%, respectively. G6PD was upregulated and its activity higher in heart failure compared to control (0.61 +/- 0.10 vs. 0.24 +/- 0.03 nmol/min/mg protein, P < 0.05), while superoxide production decreased to normal levels in the presence of the G6PD inhibitor 6-aminonicotinamide. We conclude that the activation of myocardial G6PD is a novel mechanism that enhances NADPH availability and fuels superoxide-generating enzymes in heart failure