The Process of Exercise Participation in the Community for Functional Recovery Post Formal Rehabilitation among Survivors of Stroke: a grounded theory study

The effects of stroke pose a challenge on independence and community participation, which are common goals among survivors of stroke during recovery. Exercises are implemented during rehabilitation services and have a profound effect on functional recovery; however, services are limited, where adherence levels to exercise post discharge are less than ideal. The aim of this research was to understand the process of exercise participation for functional recovery among community living survivors of stroke following discharge from formal rehabilitation. Findings of this constructivist grounded theory study provided insight into the phases leading to exercise commitment –contact with a healthcare provider, desire to improve post stroke life, navigating options, and commitment to exercise. Further, the findings gave rise to key insights, which may foster healthcare providers and community services in promoting continued exercise participation among people living with the effects of stroke

The process of commitment to exercise among stroke survivors in Canada

The objective of this research was to understand the process of commitment to exercise participation for functional recovery among community-living survivors of stroke following discharge from formal rehabilitation. Participants were recruited from a mid-sized city in south-western Ontario, Canada. Between September 2017 and March 2018, 10 individuals living in the community with the effects of stroke, who continued to engage in regular exercise post-stroke, were recruited for participation. Constructivist grounded theory methodology was employed, utilising in-depth individual interviews and theoretical sampling, whereby data collection and analysis occurred simultaneously. Analysis involved constant comparison between data and codes to reduce knowledge gaps and formulate the proposed theory. The process of commitment to exercise involved four phases. Initiation of the process followed a significant interaction with a healthcare provider who advocated for participants to learn the foundations of exercise. Through planned exercise, maintenance of a positive attitude and comparisons with their pre-stroke selves and peers, participants identified future goals and imparted the desire to get back to life before stroke. Over time individuals navigated exercise opportunities—trialling different types and environments—to learn what works. Finally, participants developed a commitment to exercise as a way of life, supported by social connections and reinforced with pride in successes—mastering self-care skills, improved mobility and meaningful function. The process of commitment to exercise among survivors of stroke required early interactions with healthcare providers to initiate exercise participation for long-term engagement, and navigation through various exercise elements fuelled by a desire to reconnect with their pre-stroke selves

The rhetoric of ecological restoration: Ethnography in the Cook County Forest Preserves

This research is an exploration of how people socially construct nature through the work of natural resource management. Using participant observation, interviews, and content analysis, I explored the experiences of staff and volunteers in the Cook County Forest Preserves to understand how they experienced and acted upon nature. In the first part, I look at how participants talked about naturalness and the contexts in which these definitions were invoked. My conclusions were that although ecological restoration requires massive human involvement in nature, it does not necessarily remove the nature-culture divide, and that naturalness is a political term applied to desirable pieces of material nature to serve desired ends. In the second part, I looked at knowledge production and the unique ways practitioners in the Cook County Forest Preserves engaged in both scientific and experiential forms of knowledge production. Practitioners used notions of science to gain validity while also disavowing the constraints of scientific methods when managing sites. I theorized that this was in part due to the incompatibility between science which seeks general principles and management which seeks site-specific solutions. I argue for a situated and reflexive natural resource management practice which makes use of both experiential and scientific modes of knowledge production in decision making

Using Mendelian randomization to determine causal effects of maternal pregnancy (intrauterine) exposures on offspring outcomes:Sources of bias and methods for assessing them

Mendelian randomization (MR), the use of genetic variants as instrumental variables (IVs) to test causal effects, is increasingly used in aetiological epidemiology. Few of the methodological developments in MR have considered the specific situation of using genetic IVs to test the causal effect of exposures in pregnant women on postnatal offspring outcomes. In this paper, we describe specific ways in which the IV assumptions might be violated when MR is used to test such intrauterine effects. We highlight the importance of considering the extent to which there is overlap between genetic variants in offspring that influence their outcome with genetic variants used as IVs in their mothers. Where there is overlap, and particularly if it generates a strong association of maternal genetic IVs with offspring outcome via the offspring genotype, the exclusion restriction assumption of IV analyses will be violated. We recommend a set of analyses that ought to be considered when MR is used to address research questions concerned with intrauterine effects on post-natal offspring outcomes, and provide details of how these can be undertaken and interpreted. These additional analyses include the use of genetic data from offspring and fathers, examining associations using maternal non-transmitted alleles, and using simulated data in sensitivity analyses (for which we provide code). We explore the extent to which new methods that have been developed for exploring violation of the exclusion restriction assumption in the two-sample setting (MR-Egger and median based methods) might be used when exploring intrauterine effects in one-sample MR. We provide a list of recommendations that researchers should use when applying MR to test the effects of intrauterine exposures on postnatal offspring outcomes and use an illustrative example with real data to demonstrate how our recommendations can be applied and subsequent results appropriately interpreted

Using structural equation modelling to jointly estimate maternal and fetal effects on birthweight in the UK Biobank

This is the author accepted manuscript. The final version is available from OUP via the DOI in this recordBackground: To date, 60 genetic variants have been robustly associated with birthweight. It is unclear whether these associations represent the effect of an individual’s own genotype on their birthweight, their mother’s genotype, or both. Methods: We demonstrate how structural equation modelling (SEM) can be used to estimate both maternal and fetal effects when phenotype information is present for individuals in two generations and genotype information is available on the older individual. We conduct an extensive simulation study to assess the bias, power and type 1 error rates of the SEM and also apply the SEM to birthweight data in the UK Biobank study. Results: Unlike simple regression models, our approach is unbiased when there is both a maternal and fetal effect. The method can be used when either the individual’s own phenotype or the phenotype of their offspring is not available, and allows the inclusion of summary statistics from additional cohorts where raw data cannot be shared. We show that the type 1 error rate of the method is appropriate, there is substantial statistical power to detect a genetic variant that has a moderate effect on the phenotype, and reasonable power to detect whether it is a fetal and/or maternal effect. We also identify a subset of birthweight associated SNPs that have opposing maternal and fetal effects in the UK Biobank. Conclusions: Our results show that SEM can be used to estimate parameters that would be difficult to quantify using simple statistical methods alone.N.M.W. is supported by a National Health and Medical Research Council Early Career Fellowship (grant number APP1104818). D.M.E. is funded by an Australian Research Council Future Fellowship (grant number FT130101709) and an Medical Research Council programme grant (grant number MC_UU_12013/4). This research has been conducted using the UK Biobank Resource. Access to the UKBB study data was funded by University of Queensland Early Career Researcher Grant (2014002959)

Effects of memory load and distraction on performance and event-related slow potentials in a visuospatial working memory task

Brain electrical activity related to working memory was recorded at 15 scalp electrodes during a visuospatial delayed response task. Participants (N = 18) touched the remembered position of a target on a computer screen after either a 1 or 8 sec delay. These memory trials were compared to sensory trials in which the target remained present throughout the delay and response periods. Distracter stimuli identical to the target were briefly presented during the delay on 30% of trials. Responses were less accurate in memory than sensory trials, especially after the long delay. During the delay slow potentials developed that were significantly more negative in memory than sensory trials. The difference between memory and sensory trials was greater at anterior than posterior electrodes. On trials with distracters, the slow potentials generated by memory trials showed further enhancement of negativity whereas there were minimal effects on accuracy of performance. The results provide evidence that engagement of visuospatial working memory generates slow wave negativity with a timing and distribution consistent with frontal activation. Enhanced brain activity associated with working memory is required to maintain performance in the presence of distraction. © 1997 by the Massachusetts Institute of Technolog

Introducing M-GCTA a Software Package to Estimate Maternal (or Paternal) Genetic Effects on Offspring Phenotypes

There is increasing interest within the genetics community in estimating the relative contribution of parental genetic effects on offspring phenotypes. Here we describe the user-friendly M-GCTA software package used to estimate the proportion of phenotypic variance explained by maternal (or alternatively paternal) and offspring genotypes on offspring phenotypes. The tool requires large studies where genome-wide genotype data are available on mother- (or alternatively father-) offspring pairs. The software includes several options for data cleaning and quality control, including the ability to detect and automatically remove cryptically related pairs of individuals. It also allows users to construct genetic relationship matrices indexing genetic similarity across the genome between parents and offspring, enabling the estimation of variance explained by maternal (or alternatively paternal) and offspring genetic effects. We evaluated the performance of the software using a range of data simulations and estimated the computing time and memory requirements. We demonstrate the use of M-GCTA on previously analyzed birth weight data from two large population based birth cohorts, the Avon Longitudinal Study of Parents and Children (ALSPAC) and the Norwegian Mother and Child Cohort Study (MoBa). We show how genetic variation in birth weight is predominantly explained by fetal genetic rather than maternal genetic sources of variation

Calculating Power to Detect Maternal and Offspring Genetic Effects in Genetic Association Studies

Offspring outcomes are a function of maternal genetics operating on the intrauterine and postnatal environment, offspring genetics and environmental factors. Partitioning genetic effects into maternal and offspring components requires genotyped mother–offspring pairs or genotyped individuals with phenotypic information on themselves and their offspring. We performed asymptotic power calculations and data simulations to estimate power to detect maternal and offspring genetic effects under a range of different study designs and models. We also developed the “Maternal and offspring Genetic effects Power Calculator” (M-GPC), an online utility which allows users to estimate the power to detect maternal and offspring genetic effects in their own studies. We find that approximately 50,000 genotyped mother–offspring pairs will be required to detect realistically sized maternal or offspring genetic effects (> 0.1% variance explained) with appreciable power (power > 90%, α = 5 × 10, two degree of freedom test), whereas greater than 10,000 pairs will be required to determine whether known genetic loci have maternal and/or offspring genetic effects (power > 78%, α = 0.05). The structural equation modelling framework espoused in this manuscript provides a natural method of combining different data structures including those present in large scale biobanks in order to maximize power to detect maternal and offspring genetic effects. We conclude that the sample sizes required to detect maternal or offspring genetic effects that explain realistic proportions of the trait variance with appreciable power are achievable and within the range of current research consortia

Owner experience and veterinary involvement with unlicensed GS-441524 treatment of feline infectious peritonitis: a prospective cohort study

IntroductionFeline Infectious Peritonitis (FIP) has historically been a fatal coronavirus disease in cats. In recent years, the therapeutic agent GS-441524, developed by Gilead Sciences, was found to be a successful treatment for FIP in most patients in clinical trials. However, this particular drug has remained stalled in the therapeutic pipeline, leaving patients and cat owners without a licensed medication. In the meantime, online social media platforms began to emerge, connecting cat owners with a community of citizen non-veterinary professionals sourcing unlicensed GS-441524.MethodsThis study prospectively followed participants (N = 141) that successfully completed 12 weeks of treatment, capturing their treatment experiences with self-administered GS-441524-like medication. A one-time survey was administered to enrolled participants with mixed format of questions (open-ended and multiple-choice) asking about treatment administration techniques, observed side effects of GS-441524, accrued cost, veterinarian involvement, impact on the cat-human bond, and social media usage.ResultsOur results show cat owners experienced a shift in treatment modality from injectable GS-441524 to pill formulation across the treatment period. The average total cost of medication has decreased since 2021 to approximately USD 3100, and participants reported the human–animal bond being affected negatively. Additionally, there was an increased trend in veterinarian awareness of GS-441524-like therapeutics and monitoring of clients undergoing treatment. Social media usage was reported as being important at the beginning of treatment to establish treatment administration but lessened by the end of treatment.DiscussionThis study is the first detailed, prospective account of owner experiences with unlicensed GS-441524, raising an important discussion surrounding citizen veterinary medicine

Investigating a Potential Causal Relationship Between Maternal Blood Pressure During Pregnancy and Future Offspring Cardiometabolic Health

Observational epidemiological studies have reported that higher maternal blood pressure (BP) during pregnancy is associated with increased future risk of offspring cardiometabolic disease. However, it is unclear whether this association represents a causal relationship through intrauterine mechanisms. We used a Mendelian randomization (MR) framework to examine the relationship between unweighted maternal genetic scores for systolic BP and diastolic BP and a range of cardiometabolic risk factors in the offspring of up to 29 708 genotyped mother-offspring pairs from the UKB study (UK Biobank) and the HUNT study (Trøndelag Health). We conducted similar analyses in up to 21 423 father-offspring pairs from the same cohorts. We confirmed that the BP-associated genetic variants from the general population sample also had similar effects on maternal BP during pregnancy in independent cohorts. We did not detect any association between maternal (or paternal) unweighted genetic scores and cardiometabolic offspring outcomes in the meta-analysis of UKB and HUNT after adjusting for offspring genotypes at the same loci. We find little evidence to support the notion that maternal BP is a major causal risk factor for adverse offspring cardiometabolic outcomes in later life