Lifestyle limitations of children and young people with severe cerebral palsy: a population study protocol

Aim.  This paper is a presentation of a study protocol to establish the prevalence of orthopaedic problems (hip dislocation, pelvic obliquity, spinal deformity and contractures) and their impact on pain, function, participation and health in a population of children and young people with severe cerebral palsy.

Background.  Cerebral palsy is the commonest cause of motor impairment in childhood and is associated with life-long disability. An estimated 30% of people with cerebral palsy have severe forms and are non-ambulant. Although the underlying neurological damage is not amenable to correction, many health services are dedicated to providing therapeutic and adaptive support to help people with the condition reach their potential.

Method.  A cross-sectional survey of children and young people, aged 4–25 years with severe, non-ambulant cerebral palsy as defined using the Gross Motor Function Classification System (Levels IV and V). Study participants will be identified from a pre-existing, geographically defined case register and recruited via a healthcare professional known to them. Two assessments will be undertaken: one involving parents/carers at home and using questionnaires; the other involving the child/young person ideally in one of three settings and including X-rays if clinically indicated.

Discussion.  This study will contribute to our knowledge of the history and epidemiology of orthopaedic problems in children and young people with cerebral palsy and how these problems accumulate and impact on participation, health and well-being. The study will also identify unmet need and make recommendations for good practice in relation to the orthopaedic care and management for people with severe cerebral palsy

An examination of the rheological and mucoadhesive properties of poly(Acrylic acid) organogels designed as platforms for local drug delivery to the oral cavity

This study examined the rheological/mucoadhesive properties of poly (acrylic acid) PAA organogels as platforms for drug delivery to the oral cavity. Organogels were prepared using PAA (3%, 5%, 10% w/w) dissolved in ethylene glycol (EG), propylene glycol (PG), 1,3-propylene glycol (1,3-PG), 1,5-propanediol (1,5-PD), polyethylene glycol 400 (PEG 400), or glycerol. All organogels exhibited pseudoplastic flow. The increase in storage (G') and loss (G '') moduli of organogels as a function of frequency was minimal, G '' was greater than G '' (at all frequencies), and the loss tangent <1, indicative of gel behavior. Organogels prepared using EG, PG, and 1,3-propanediol (1,3-PD) exhibited similar flow/viscoelastic properties. Enhanced rheological structuring was associated with organogels prepared using glycerol (in particular) and PEG 400 due to their interaction with adjacent carboxylic acid groups on each chain and on adjacent chains. All organogels (with the exception of 1,5-PD) exhibited greater network structure than aqueous PAA gels. Organogel mucoadhesion increased with polymer concentration. Greatest mucoadhesion was associated with glycerol-based formulations, whereas aqueous PAA gels exhibited the lowest mucoadhesion. The enhanced network structure and the excellent mucoadhesive properties of these organogels, both of which may be engineered through choice of polymer concentration/solvent type, may be clinically useful for the delivery of drugs to the oral cavity.

Antimicrobial activity of neuropeptides against a range of micro-organisms from skin, oral, respiratory and gastrointestinal tract sites

Many neuropeptides are similar in size, amino acid composition and charge to antimicrobial peptides. This study aimed to determine whether the neuropeptides substance P (SP), neurokinin A (NKA), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP), displayed antimicrobial activity against Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. SP, NPY, VIP and CGRP displayed variable degrees of antimicrobial activity against all the pathogens tested with the exception of S. aureus. These antimicrobial activities add a further dimension to the immunomodulatory roles for neuropeptides in the inflammatory and immune responses. (c) 2008 Elsevier B.V. All rights reserved.

Spectrally efficient cooperative diversity protocol for uplink wireless transmission

A spectrally efficient cooperative protocol for uplink wireless transmission in a centralised communication system is proposed, where each of the N users play the relaying and source roles simultaneously by using superposition (SP) modulation. The probability density function of the mutual information between SP-modulated transmitted and received signals of the cooperative uplink channels is derived. Using the high-signal-to-noise ratio (SNR) approximation of this density function, the outage probability formula of the system as well as its easily computable tight upper and lower bounds are obtained and these formulas are evaluated numerically. Numerical results show that the proposed strategy can achieve around 3 dB performance gain over comparable schemes. Furthermore, the multiplexing and diversity tradeoff formula is derived to illustrate the optimal performance of the proposed protocol, which also confirms that the SP relaying transmission does not cause any loss of data rate. Moreover, performance characterisation in terms of ergodic and outage capacities are studied and numerical results show that the proposed scheme can achieve significantly larger outage capacity than direct transmission, which is similar to other cooperative schemes. The superiority of the proposed strategy is demonstrated by the fact that it can maintain almost the same ergodic capacity as the direct transmission, whereas the ergodic capacity of other cooperative schemes would be much worse.

Cooperative transmission protocol with full diversity and iterative detection

The authors propose a three-node full diversity cooperative protocol, which allows the retransmission of all symbols. By allowing multiple nodes to transmit simultaneously, relaying transmission only consumes limited bandwidth resource. To facilitate the performance analysis of the proposed cooperative protocol, the lower and upper bounds of the outage probability are first developed, and then the high signal-to-noise ratio behaviour is studied. Our analytical results show that the proposed strategy can achieve full diversity. To achieve the performance gain promised by the cooperative diversity, at the relays decode-and-forward strategy is adopted and an iterative soft-interference-cancellation minimum mean-squared error equaliser is developed. The simulation results compare the bit-error-rate performance of the proposed protocol with the non-cooperative scheme and the scheme presented by Azarian et al. ( 2005).