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

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

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

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

Associations of sedentary behaviour, physical activity, blood pressure and anthropometric measures with cardiorespiratory fitness in children with cerebral palsy

Background - Children with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. Poor cardiorespiratory fitness may contribute to increased cardiometabolic risk. Purpose - The aim of this study was to determine the association between sedentary behaviour, physical activity and cardiorespiratory fitness in children with CP. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP. Methods- This study included 55 ambulatory children with CP [mean (SD) age 11.3 (0.2) yr, range 6-17 yr; Gross Motor Function Classification System (GMFCS) levels I and II]. Anthropometric measures (BMI, waist circumference and waist-height ratio) and blood pressure were taken. Cardiorespiratory fitness was measured using a 10 m shuttle run test. Children were classified as low, middle and high fitness according to level achieved on the test using reference curves. Physical activity was measured by accelerometry over 7 days. In addition to total activity, time in sedentary behaviour and light, moderate, vigorous, and sustained moderate-to-vigorous activity (≥10 min bouts) were calculated. Results - Multiple regression analyses revealed that vigorous activity (β = 0.339, p<0.01), sustained moderate-to-vigorous activity (β = 0.250, p<0.05) and total activity (β = 0.238, p<0.05) were associated with level achieved on the shuttle run test after adjustment for age, sex and GMFCS level. Children with high fitness spent more time in vigorous activity than children with middle fitness (p<0.05). Shuttle run test level was negatively associated with BMI (r2 = -0.451, p<0.01), waist circumference (r2 = -0.560, p<0.001), waist-height ratio (r2 = -0.560, p<0.001) and systolic blood pressure (r2 = -0.306, p<0.05) after adjustment for age, sex and GMFCS level. Conclusions - Participation in physical activity, particularly at a vigorous intensity, is associated with high cardiorespiratory fitness in children with CP. Low cardiorespiratory fitness is associated with increased cardiometabolic risk