Mand – to Tact Training Transfer Acquisition Rates in Children Diagnosed with Autism Spectrum Disorder with Limited Verbal Skills

Autism Spectrum Disorder () is defined as “the presence of severe and pervasive impairments in reciprocal social interaction and in verbal and nonverbal communication skills” (Diagnostic & Statistical Manual, 2000). It is estimated that 1 in 68 children across the United States are diagnosed with ASD. One of the most common delays that children diagnosed with ASD experience are language delays. Children with ASD that have a language delay will often develop maladaptive behaviors as a result of poor communication skills (Carr & Durand, 1985). The failure to develop mand acquisition in typical fashion results in behaviors ranging from social withdrawal to self-injurious behaviors (Cooper et. al, 2007). A lack of a strong tact repertoire can further impede and complicate the learning of other necessary components of language due to the inability to successfully label items and events in the physical environment of the child. The purpose of this study is to replicate with a reversal in verbal operant training of the procedures described in Wallace et al. (2006) in which two children with ASD underwent tact training to facilitate the formation of mands; essentially this study aims to accomplish mand training first to establish as tact. It is hypothesized that mand training will result in a greater repertoire of tacts due to strength of the relationship between mands and the control over the social environment (Cooper et al., 2007). The two children in the study will be taught to mand items that will be ranked in order of preference via stimulus preference assessment. This study is of great importance due to the indispensable value of effective social communication skills. Data gathered on improving communication skills is of great value to the ASD community as the implications for functional skills result in better communication with family and greater control of individual functioning.

Mand – to Tact Training Transfer Acquisition Rates in Children Diagnosed with Autism Spectrum Disorder with Limited Verbal Skills

Autism Spectrum Disorder () is defined as “the presence of severe and pervasive impairments in reciprocal social interaction and in verbal and nonverbal communication skills” (Diagnostic & Statistical Manual, 2000). It is estimated that 1 in 68 children across the United States are diagnosed with ASD. One of the most common delays that children diagnosed with ASD experience are language delays. Children with ASD that have a language delay will often develop maladaptive behaviors as a result of poor communication skills (Carr & Durand, 1985). The failure to develop mand acquisition in typical fashion results in behaviors ranging from social withdrawal to self-injurious behaviors (Cooper et. al, 2007). A lack of a strong tact repertoire can further impede and complicate the learning of other necessary components of language due to the inability to successfully label items and events in the physical environment of the child. The purpose of this study is to replicate with a reversal in verbal operant training of the procedures described in Wallace et al. (2006) in which two children with ASD underwent tact training to facilitate the formation of mands; essentially this study aims to accomplish mand training first to establish as tact. It is hypothesized that mand training will result in a greater repertoire of tacts due to strength of the relationship between mands and the control over the social environment (Cooper et al., 2007). The two children in the study will be taught to mand items that will be ranked in order of preference via stimulus preference assessment. This study is of great importance due to the indispensable value of effective social communication skills. Data gathered on improving communication skills is of great value to the ASD community as the implications for functional skills result in better communication with family and greater control of individual functioning.

Study protocol of European Fans in Training (EuroFIT) : a four-country randomised controlled trial of a lifestyle program for men delivered in elite football clubs

Funding The EuroFIT study is funded by the European Union’s Seventh Framework Program for research technological development and demonstration under Grant Agreement no: 602170. The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates.

Individual Variation in VO2peak Response Following Sprint Interval Training: The Role of Peripheral Adaptation

There is a large degree of heterogeneity in response to regular physical activity at the individual level, with some exhibiting no or very small improvements in VO2peak following highly controlled exercise training. The purpose of this thesis was to examine individual variation in VO2peak response to sprint interval training (SIT) in relation to individual responses to multiple measures of peripheral physiological adaptation. Specifically, VO2peak, capillary density, fibre-specific SDH content, and type I fibre % were measured in 23 young, healthy, recreationally active males before and after 4 weeks SIT (Tabata protocol 4 x per week). The key findings of this experiment included that, when separated into tertiles of VO2peak response, the high (HI) and low (LO) groups differed significantly in VO2peak change after training. Secondly, there was no difference between HI and LO groups for response in any of capillary density, fibre-specific SDH content, or fibre type %, with no correlation found between individual VO2peak response and changes in any measured peripheral variable. Together, these results confirm that individuals respond heterogeneously to SIT and suggest that this heterogeneity does not result from differences in individual changes in capillary density, fibre-specific SDH content or type I fibre %. It is speculated that some other combination of peripheral physiological adaptation must explain variability in VO2peak response to 4 weeks of SIT.

Staff training in autism: The one-eyed wo/man….

Having well-trained staff is key to ensuring good quality autism services, especially since people affected with autism generally tend to have higher support needs than other populations in terms of daily living as well as their mental and physical health. Poorly-trained staff can have detrimental effects on service provision and staff morale and can lead to staff burn-out as well as increased service user anxiety and stress. This paper reports on a survey with health, social care, and education staff who work within the statutory autism services sector in the UK that explored their knowledge and training with regards to autism. Interview data obtained from staff and service users offer qualitative illustrations of survey findings. Overall, the findings expose an acute lack of autism specific training that has detrimental impacts. At best this training was based on brief and very basic awareness raising rather than on in-depth understanding of issues related to autism or skills for evidence-based practice. Service users were concerned with the effects that lack of staff training had on the services they received. The paper concludes with a discussion of policy routes to achieving quality staff training based on international best practice. The focus is on improving the quality of life and mental health for services users and staff as well as making potentially significant cost-savings for governments.

There is something about Mary… and Ted! : Training in mixed-sex groups makes you work harder. A study about the effort when training with the opposite sex.

In many sport associations, regardless of level, women and men rarely practice together. Previous studies indicate that work groups are generally more efficient when there is an even distribution between the sexes. Could that also be the case in sports? This study aims to investigate whether the sex composition of a training group affects the effort and performance of the participants. Eleven volunteers participated in the crossover study consisting of three different 150-meter sprint conditions; individually, single-sex group and mixed-sex group. Sprint times, heart rate and RPE were recorded during all three trials. The result of this study suggests that there might be practical benefits in regards to physical performance and effort to exercise in a training group consisting of both sexes instead of training only with the same-sex or individually. The understanding could be useful in areas such as; training optimisation for both athletes and in patient- and rehabilitation groups, increasing efficiency in work environments, in schools and sports clubs striving for both athletic success and gender equality.

Measurement of Training Intensity and Work During Submaximal Isokinetic Progressive Resistance Training Protocols

Physical exercise programmes are routinely prescribed in clinical practice to treat impairments, improve activity and participation in daily life because of their known physiological, health and psychological benefits (RCP, 2009). Progressive resistance exercise is a type of exercise prescribed specifically to improve skeletal muscle strength (Latham et al., 2004). The effectiveness of progressive resistance exercise varies considerably between studies and populations. This thesis focuses on how training parameters influence the delivery of progressive resistance exercise. In order to appropriately evaluate the influence of training parameters, this thesis argues the need to record training performance and the total work completed by participants as prescribed by training protocols. In the first study, participants were taken through a series of protocols differentiated by the intensity and volume of training. Training intensity was defined as a proportion of the mean peak torque achieved during maximal voluntary contractions and was set at 80% and 40% respectively of the MVC mean peak torque. Training volume was defined as the total external work achieved over the training period. Measures of training performance were developed to accurately report the intensity, repetitions and work completed during the training period. A second study evaluated training performance of the training protocols over repeated sessions. These protocols were then applied to 3 stroke survivors. Study 1 found sedentary participants could achieve a differentiated training intensity. Participants completing the high and low intensity protocols trained at 80% and 40% respectively of the MVC mean peak torque. The total work achieved in the high intensity low repetition protocol was lower than the total work achieved in the low intensity high repetition protocol. With repeated practice, study 2 found participants were able to improve in their ability to perform manoeuvres as shown by a reduction in the variation of the mean training intensity achieving total work as specified by the protocol to a lower margin of error. When these protocols were applied to 3 stroke survivors, they were able to achieve the specified training intensity but they were not able to achieve the total work as expected for the protocol. This is likely to be due to an inability in achieving a consistent force throughout the contraction. These results demonstrate evaluation of training characteristics and support the need to record and report training performance characteristics during progressive resistance exercise, including the total work achieved, in order to elucidate the influence of training parameters on progressive resistance exercise. The lack of accurate training performance may partly explain the inconsistencies between studies on optimal training parameters for progressive resistance exercise.

Effect of information feedback on training standing up following stroke : a pilot feasibilty study

Swimming training repercussion on metabolic and structural bone development: benefits of the incorporation of whole body vibration or pilometric training; the RENACIMIENTO project

Introduction: Enviromental factors such as exercise participation and nutrition have often been linked to bone improvements. However, not all sports have the same effects, being non-osteogenic sports such as swimming defined as negative or neutral sports to practice regarding bone mass by some authors, similarly exercise-diet interaction in especific groups is still not clear. Objective: To present the methodology of the RENACIMENTO project that aims to evaluate body composition and more specifically bone mass by several techniques in adolescent swimmers and to observe the effects and perdurability of whole body vibration (WBV) and jumping intervention (JIN) on body composition and fitness on this population and explore posible diet interactions. Design: Randomized controlled trial. Methods: 78 swimmers (12-17 y) and 26 sex- and age-matched controls will participate in this study. Dual energy X-ray, peripheral Quantitative Computed Tomography, Quantitative Ultrasound, Bioelectrical Impedance Analysis, and anthropometry measurements will be performed in order to evaluate body composition. Physical activity, nutrition, pubertal development and socio-economical status may act as confounders of body composition and therefore will also be registered. Several fitness factors regarding strength, endurance, performance and others will also be registered to evaluate differences with controls and act as confounders. A 7-month WBV therapy will be performed by 26 swimmers consisting of a training of 15 minutes 3 times per week. An 8 month JIM will also be performed by 26 swimmers 3 times per week. The remaining 26 swimmers will continue their normal swimming training. Four evaluations will be performed, the first one in order to describe differences between swimmers and controls. The second one to describe the effects of the interventions and the third and fourth evaluations to describe the perdurability of the effects of the WBV and JIN. Conclusion: The RENACIMIENTO project will allow to answer several questions regarding body composition, fitness, bone mass and interaction with diet of adolescent swimmers, describe swimming as a positive, negative or neutral sport to practice regarding these parameters and elucidate the effects and perdurability of WBV and JIM on body composition.

A rehabilitation intervention to promote physical recovery following intensive care: a detailed description of construct development, rationale and content together with proposed taxonomy to capture processes in a randomised controlled trial.

Background: increasing numbers of patients are surviving critical illness, but survival may be associated with a constellation of physical and psychological sequelae that can cause on going disability and reduced health-related quality of life. Limited evidence currently exists to guide the optimum structure, timing, and content of rehabilitation programmes. There is a need to both develop and evaluate interventions to support and expedite recovery during the post-ICU discharge period. This paper describes the construct development for a complex rehabilitation intervention intended to promote physical recovery following critical illness. The intervention is currently being evaluated in a randomised trial (ISRCTN09412438; funder Chief Scientists Office, Scotland). Methods: the intervention was developed using the Medical Research Council (MRC) framework for developing complex healthcare interventions. We ensured representation from a wide variety of stakeholders including content experts from multiple specialties, methodologists, and patient representation. The intervention construct was initially based on literature review, local observational and audit work, qualitative studies with ICU survivors, and brainstorming activities. Iterative refinement was aided by the publication of a National Institute for Health and Care Excellence guideline (No. 83), publicly available patient stories (Healthtalkonline), a stakeholder event in collaboration with the James Lind Alliance, and local piloting. Modelling and further work involved a feasibility trial and development of a novel generic rehabilitation assistant (GRA) role. Several rounds of external peer review during successive funding applications also contributed to development. Results: the final construct for the complex intervention involved a dedicated GRA trained to pre-defined competencies across multiple rehabilitation domains (physiotherapy, dietetics, occupational therapy, and speech/language therapy), with specific training in post-critical illness issues. The intervention was from ICU discharge to 3 months post-discharge, including inpatient and post-hospital discharge elements. Clear strategies to provide information to patients/families were included. A detailed taxonomy was developed to define and describe the processes undertaken, and capture them during the trial. The detailed process measure description, together with a range of patient, health service, and economic outcomes were successfully mapped on to the modified CONSORT recommendations for reporting non-pharmacologic trial interventions. Conclusions: the MRC complex intervention framework was an effective guide to developing a novel post-ICU rehabilitation intervention. Combining a clearly defined new healthcare role with a detailed taxonomy of process and activity enabled the intervention to be clearly described for the purpose of trial delivery and reporting. These data will be useful when interpreting the results of the randomised trial, will increase internal and external trial validity, and help others implement the intervention if the intervention proves clinically and cost effective.

Men's experiences of receiving objective feedback on physical activity and other indicators of health risk, within the context of a gender-sensitised weight loss intervention

Receiving personalised feedback on body mass index and other health risk indicators may prompt behaviour change. Few studies have investigated men’s reactions to receiving objective feedback on such measures and detailed information on physical activity and sedentary time. The aim of my research was to understand the meanings different forms of objective feedback have for overweight/obese men, and to explore whether these varied between groups. Participants took part in Football Fans in Training, a gender-sensitised, weight loss programme delivered via Scottish Professional Football Clubs. Semi-structured interviews were conducted with 28 men, purposively sampled from four clubs to investigate the experiences of men who achieved and did not achieve their 5% weight loss target. Data were analysed using the principles of thematic analysis and interpreted through Self-Determination Theory and sociological understandings of masculinity. Several factors were vital in supporting a ‘motivational climate’ in which men could feel ‘at ease’ and adopt self-regulation strategies: the ‘place’ was described as motivating, whereas the ‘people’ (other men ‘like them’; fieldwork staff; community coaches) provided supportive and facilitative roles. Men who achieved greater weight loss were more likely to describe being motivated as a consequence of receiving information on their objective health risk indicators. They continued using self-monitoring technologies after the programme as it was enjoyable; or they had redefined themselves by integrating new-found activities into their lives and no longer relied on external technologies/feedback. They were more likely to see post-programme feedback as confirmation of success, so long as they could fully interpret the information. Men who did not achieve their 5% weight loss reported no longer being motivated to continue their activity levels or self-monitor them with a pedometer. Social support within the programme appeared more important. These men were also less positive about objective post-programme feedback which confirmed their lack of success and had less utility as a motivational tool. Providing different forms of objective feedback to men within an environment that has intrinsic value (e.g. football club setting) and congruent with common cultural constructions of masculinity, appears more conducive to health behaviour change.

Assessment oxidative stress biomarkers –neuroprostanes and dihomo-isoprostanes- in elite triathletes urine after two weeks of moderate altitude training

This randomized and controlled trial investigated whether the increase in elite training at different altitudes altered the oxidative stress biomarkers of the nervous system. This is the first study to investigate four F4-neuroprostanes and four F2-dihomo-isoprostanes quantified in 24-hour urine. The quantification was carried out by Ultra High Pressure Liquid Chromatography-triple Quadrupole-Tandem Mass Spectrometry (UHPLC-QqQ-MS/MS). Sixteen elite triathletes agreed to participate in the project. They were randomized in two groups, a group submitted to Altitude Training (n=8) and a group submitted to Sea Level Training (n=8), with a Control group of non-athletes (n=8). After experimental period, the Altitude Training group triathletes gave significant data: 17-epi-17-F2t-dihomo-IsoP (from 5.2 ± 1.4 µg/mL 24 h-1 to 6.6 ± 0.6 µg/mL 24 h-1), ent-7(RS)-7-F2t-dihomo-IsoP (from 6.6 ± 1.7 µg/mL 24 h-1 to 8.6 ± 0.9 µg /mL 24 h-1), and ent-7-epi-7-F2t-dihomo-IsoP (from 8.4 ± 2.2 µg/mL 24 h-1 to 11.3 ± 1.8 µg/mL 24 h-1) increased, while, of the neuronal degeneration-related compounds, only 10-epi-10-F4t-NeuroP (8.4 ± 1.7 µg/mL 24 h-1) and 10-F4t-NeuroP (5.2 ± 2.9 µg/mL 24 h-1) were detected in this group. For the control group and sea level training groups, no significant changes had occurred at the end of the 2-weeks experimental period. Therefore, and as the main conclusion, the training at moderate altitude increased the F4-NeuroPs- and F2-dihomo-isoPs-related oxidative damage of the central nervous system (CNS) compared to similar training at sea level.