Age-related changes in energy efficiency of gait, activity, and participation in children with cerebral palsy

Aim
The aim of this study was to use a prospective longitudinal study to describe age-related trends in energy efficiency during gait, activity, and participation in ambulatory children with cerebral palsy (CP).

Method
Gross Motor Function Measure (GMFM), Paediatric Evaluation of Disability Inventory (PEDI), and Lifestyle Assessment Questionnaire-Cerebral Palsy (LAQ-CP) scores, and energy efficiency (oxygen cost) during gait were assessed in representative sample of 184 children (112 male; 72 female; mean age 10y 9mo; range 4–16y) with CP. Ninety-four children had unilateral spastic CP, 84 bilateral spastic CP, and six had other forms of CP. Fifty-seven were classified as Gross Motor Function Classification System (GMFCS) level I, 91 as level II, 22 as level III, and 14 as level IV). Assessments were carried out on two occasions (visit 1 and visit 2) separated by an interval of 2 years and 7 months. A total of 157 participants returned for reassessment.

Results
Significant improvements in mean raw scores for GMFM, PEDI, and LAQ-CP were recorded; however, mean raw oxygen cost deteriorated over time. Age-related trends revealed gait to be most inefficient at the age of 12 years, but GMFM scores continued to improve until the age of 13 years, and two PEDI subscales to age 14 years, before deteriorating (p<0.05). Baseline score was consistently the single greatest predictor of visit 2 score. Substantial agreement in GMFCS ratings over time was achieved (?lw=0.74–0.76).

Interpretation
These findings have implications in terms of optimal provision and delivery of services for young people with CP to maximize physical capabilities and maintain functional skills into adulthood.

ABSOLUTE DOUBLY DIFFERENTIAL CROSS-SECTIONS FOR ELECTRON-EMISSION IN COLLISIONS OF 3.5-MEV/U FE(17+) AND FE(22+) IONS WITH HE AND AR GAS TARGETS

Absolute doubly differential cross sections have been measured as a function of electron energy and angle of observation for electron emission in collisions of 3.5-MeV/u Fe17+ and Fe22+ ions with He and Ar gas targets under single-collision conditions. The measured electron emission cross sections are compared to theoretical and scaled cross sections based on the Born approximation. The results using intermediate-mass ions are discussed with reference to previously reported cross sections from collisions with highly charged lighter- and heavier-ion species at MeV/u projectile energies. The continuum-distorted-wave-eikonal-initial-state approximation shows good agreement with experiments except in the

Phase I and II biotransformation enzymes and polycyclic aromatic hydrocarbons in the Mediterranean mussel (Mytilus galloprovincialis, Lamarck, 1819) collected in front of an oil refinery

The aim of the present study was to investigate the responses of phase I and II biotransformation enzymes and levels of PAHs in the Mediterranean mussel (Mytilus galloprovincialis, Lamarck, 1819) collected from three sites at different distance from an oil refinery. Phase I enzyme activities as NAD(P)H-cyt c red, NADH ferry red, B(a)PMO and phase II as UDPGT. GST were measured in digestive gland while 16 PAHs (US-EPA) in whole soft tissue. An added value to the data obtained in the present study rely on the RDA analysis which showed close correlations between PAHs levels and phase I enzyme activities in mussels collected in front of the refinery. And again a significant spatial correlation between B(a)P levels and NADPH-cyt c red activities was observed using linear models. No differences among sites for B(a) PMO and phase II GST activities were observed, while the application of UDPGT as biomarkers requires further investigation. (C) 2012 Elsevier Ltd. All rights reserved.

Fasciola hepatica:development of monoclonal antibodies and their use to characterize a glycocalyx antigen in migrating flukes

Using mice harbouring early Fasciola hepatica infections, six monoclonal antibodies were prepared against a tegumental antigen present in T1 granules and glycocalyx of flukes. Blocking tests indicated that all monoclonals bound the same T1 epitope (or epitopes in close proximity on the antigen molecule), but this was not the determinant recognized by sheep and cattle. Localization of antibody binding at light and electron microscope levels showed that T1-type antigen also occurred in metacercarial tegument and in glycocalyx of gut cells and excretory ducts in juvenile and adult flukes. This indicates that the natural host-antibody response to F. hepatica may be to one antigen early in the infection. Protein A-gold labelling of monoclonal treated fluke sections revealed that the epitope was probably a polypeptide, unmodified by glycosylation in Golgi bodies. When isolated by immunoadsorption and separated electrophoretically under reducing conditions T1-type antigen was found to consist of a polypeptide mol. wt. 50 000, possibly linked to smaller entities mol. wt. 25-40 000. Tissue-specific variations in the antigen molecule might be conferred by linkage of different polypeptides or carbohydrate side-chains to an antigenic core polypeptide. A component of T1-type antigen was found to have mol. wt. of 25 000, possibly resembling a polypeptide of mol. wt. 24 000 from Schistosoma mansoni tegument.

The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK).

Background
The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention.

Methods
Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff.

Results
Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision.

Conclusions
We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes.

Quantifying heritable variation in fitness-related traits of wild, farmed and hybrid Atlantic salmon families in a wild river environment

Farmed fish are typically genetically different from wild conspecifics. Escapees from fish farms may contribute one-way gene flow from farm to wild gene pools, which can depress population productivity, dilute local adaptations and disrupt coadapted gene complexes. Here, we reanalyse data from two experiments (McGinnity et al., 1997, 2003) where performance of Atlantic salmon (Salmo salar) progeny originating from experimental crosses between farm and wild parents (in three different cohorts) were measured in a natural stream under common garden conditions. Previous published analyses focussed on group-level differences but did not account for pedigree structure, as we do here using modern mixed-effect models. Offspring with one or two farm parents exhibited poorer survival in their first and second year of life compared with those with two wild parents and these group-level inferences were robust to excluding outlier families. Variation in performance among farm, hybrid and wild families was generally similar in magnitude. Farm offspring were generally larger at all life stages examined than wild offspring, but the differences were moderate (5–20%) and similar in magnitude in the wild versus hatchery environments. Quantitative genetic analyses conducted using a Bayesian framework revealed moderate heritability in juvenile fork length and mass and positive genetic correlations (>0.85) between these morphological traits. Our study confirms (using more rigorous statistical techniques) previous studies showing that offspring of wild fish invariably have higher fitness and contributes fresh insights into family-level variation in performance of farm, wild and hybrid Atlantic salmon families in the wild. It also adds to a small, but growing, number of studies that estimate key evolutionary parameters in wild salmonid populations. Such information is vital in modelling the impacts of introgression by escaped farm salmon.

Challenges and barriers in primary school education: The experiences of Traveller children and young people in Northern Ireland

Exclusion, discrimination and widespread disadvantage are issues common to the Traveller community. Children from the Traveller community are often seen as the most at risk within the education system in respect of attendance, attainment and bullying. In this article, we consider the views of Traveller children and parents with respect to primary level education in Northern Ireland and assess the level of support that exists to help Traveller children within the education system. The findings from the research are discussed with reference to institutional discrimination and the varying experiences of children and their families, including an identification of positive attitudes to education contrary to typical stereotypes.

Effervescent and standard formulations of ranitidine--a comparison of their pharmacokinetics and pharmacology

An effervescent formulation of ranitidine may be absorbed faster and achieve a faster onset of action than conventional tablet form. The aim of this study was to compare the effects of effervescent formulations of ranitidine with equivalent dose standard tablets, in terms of intragastric pH and plasma pharmacokinetics in the initial 6 h following dosing.

Is Early Warning Effective for the Improvement of Problem Solving and Project Performance?

Since the first launch of the new engineering contract (NEC) in 1993, early warning of problems has been widely recognized as an important approach of proactive management during a construction or engineering project. Is early warning really effective for the improvement of problem solving and project performance? This is a research question that still lacks a good answer. For this reason, an empirical investigation was made in the United Kingdom (U.K.) to answer the question. This study adopts a combination of literature review, expert interview, and questionnaire survey. Nearly 100 questionnaire responses were collected from the U.K. construction industry, based on which the use of early warning under different forms of contract is compared in this paper. Problem solving and project performance are further compared between the projects using early warning and the projects not using early warning. The comparison provides clear evidence for the significant effect of early warning on problem solving and project performance in terms of time, cost, and quality. Subsequently, an input-process-output model is developed in this paper to explore the relationship among early warning, problem solving, and project
performance. All these help construction researchers and practitioners to better understand the role of early warning in ensuring project success.

Religion in Times of Crisis

Religion is alive and well all over the world, especially in times of personal, political, and social crisis. Even in Europe, long regarded as the most 'secular' continent, religion has taken centre stage in how people respond to the crises associated with modernity, or how they interact with the nation-state. In this book, scholars working in and on Europe offer fresh perspectives on how religion provides answers to existential crisis, how crisis increases the salience of religious identities and cultural polarization, and how religion is contributing to changes in the modern world in Europe and beyond. Cases from Poland to Pakistan and from Ireland to Zimbabwe, among others, demonstrate the complexity and ambivalence of religion's role in the contemporary world.

Home-range size in juveniles of the temperate reef fish, the common triplefin (Forsterygion lapillum)

An organism’s home range dictates the spatial scale on which important processes occur (e.g. competition and predation) and directly affects the relationship between individual fitness and local habitat quality. Many reef fish species have very restricted home ranges after settlement and, here, we quantify home-range size in juveniles of a widespread and abundant reef fish in New Zealand, the common triplefin (Forsterygion lapillum). We conducted visual observations on 49 juveniles (mean size = 35-mm total length) within the Wellington harbour, New Zealand. Home ranges were extremely small, 0.053 m2 ± 0.029 (mean ± s.d.) and were unaffected by adult density, body size or substrate composition. A regression tree indicated that home-range size sharply decreased ~4.5 juveniles m–2 and a linear mixed model confirmed that home-range sizes in high-density areas (>4.5 juveniles m–2) were significantly smaller (34%) than those in low-density areas (after accounting for a significant effect of fish movement on our home-range estimates). Our results suggest that conspecific density may have negative and non-linear effects on home-range size, which could shape the spatial distribution of juveniles within a population, as well as influence individual fitness across local density gradients.

Murray v McCullough (as Nominee on Behalf of the Trustees and on Behalf of the Board of Governors of Rainey Endowed School) [2016] NIQB 52

Considers the Northern Ireland Queen’s Bench Division ruling in Murray v McCullough concerning the duty of care incumbent upon the school with regard to the wearing of mouth guards by pupils when playing hockey. Comments on the limitations of the legal doctrine of in loco parentis in cases of professional negligence and, how ‘sports law’ jurisprudence might prove instructive in sports negligence cases.

Reading Elizabeth Bishop's "Artifact of [Words]"

As Emerson noted in his essay 'The Poet' "we are not pans and barrows, not even porters of the fire and torch-bearers, but children of the fire, made of it, and only the same divinity transmuted, and at two or three removes, when we least know about it." For Emerson, the fire is poetry, an elemental force capable of transmutation, transformation and enduring relevance. Moving from Emerson, Elizabeth Bishop rises as the twentieth-century poet most aligned with the possibility of poetry and the powers of its practice, as 'At The Fishhouses' indicates in her clear referencing of Emerson:

"If you should dip your hand in,
your wrist would ache immediately,
your bones would begin to ache and your hand would burn
as if the water were a transmutation of fire
that feeds on stones and burns with a dark gray flame."

This essay will look in detail at Bishop's understanding of the possibility of poetry and how art functions as a multi-dimensional structure that is unsettled as much as it unsettles. In particular, Bishop's poem 'The Monument' will be unpicked as testament both to the practice of Bishop's art and also the role of the poet critic responding to what they uncover