Vitamin D status and latent tuberculosis infection : a preliminary study in a group of healthy Mexican agricultural workers

Vitamin D metabolites are important in the regulation of bone and calcium homeostasis, but also have a more ubiquitous role in the regulation of cell differentiation and immune function. Severely low circulating 25-dihydroxyvitamin D [25(OH)D] concentrations have been associated with the onset of active tuberculosis (TB) in immigrant populations, although the association with latent TB infection (LTBI) has not received much attention. A previous study identified the prevalence of LTBI among a sample of Mexican migrant workers enrolled in Canada's Seasonal Agricultural Workers Program (SA WP) in the Niagara Region of Ontario. The aim of the present study was to determine the vitamin D status of the same sample, and identify if a relationship existed with LTBI. Studies of vitamin D deficiency and active TB are most commonly carried out among immigrant populations to non-endemic regions, in which reactivation of LTBI has occurred. Currently, there is limited knowledge of the association between vitamin D deficiency and LTBI. Entry into Canada ensured that these individuals did not have active TB, and L TBI status was established previously by an interferon-gamma release assay (IGRA) (QuantiFERON-TB Gold In-Tube®, Cellestis Ltd., Australia). Awareness of vitamin D status may enable individuals at risk of deficiency to improve their nutritional health, and those with LTBI to be aware of this risk factor for disease. Prevalence of vitamin D insufficiency among the Mexican migrant workers was determined from serum samples collected in the summer of 2007 as part of the cross sectional LTBI study. Samples were measured for concentrations of the main circulating vitamin D metabolite, 25(OH)D, with a widely used 1251 250HD RIA (DiaSorin Inc.®, Stillwater, MN), and were categorized as deficient «37.5 nmoI/L), insufficient (>37.5 nmollL, < 80 nmol/L) or sufficient (2::80 nmoI/L). Fisher's exact tests and t tests were used to determine if vitamin D status (sufficiency or insufficiency) or 25(OH)D concentrations significantly differed by sex or age categories. Predictors of vitamin D insufficiency and 25(OH)D concentrations were taken from questionnaires carried out during the previous study, and analyzed in the present study using multiple regression prediction models. Fisher's exact test and t test was used to determine if vitamin D status or 25(OH)D concentration differed by LTBI status. Strength of the relationship between interferongamma (IFN-y) concentration (released by peripheral T cells in response to TB antigens) and 25(OH)D concentration was analyzed using a Spearman correlation. Out of 87 participants included in the study (78% male; mean age 38 years), 14 were identified as LTBI positive but none had any signs or symptoms of TB reactivation. Only 30% of the participants were vitamin D sufficient, whereas 68% were insufficient and 2% were deficient. Significant independent predictors of lower 25(OH)D concentrations were sex, number of years enrolled in the SA WP and length of stay in Canada. No significant differences were found between 25(OH)D concentrations and LTBI status. There was a significant moderate correlation between IFN-y and 25(OH)D concentrations ofLTBI-positive individuals. The majority of participants presented with Vitamin D insufficiency but none were severely deficient, indicating that 25(OH)D concentrations do not decrease dramatically in populations who temporarily reside in Canada but go back to their countries of origin during the Canadian winter. This study did not find a statistical relationship between low levels of vitamin D and LTBI which suggests that in the presence of overall good health, lower than ideal levels of 2S(OH)D, may still be exerting a protective immunological effect against LTBI reactivation. The challenge remains to determine a critical 2S(OH)D concentration at which reactivation is more likely to occur.

Muscle strength and activation characteristics of power- trained and non-athlete boys and men

During maturation, muscle strength is enhanced through muscle growth, although neuro-muscular factors are also believed to be involved. In adults, training for power sports has been shown to enhance muscle strength and activation. The purpose of this study was to examine muscle strength and activation in power-trained athletes (POW) compared with non-athletes (CON), in boys and in adults. After familiarization subjects performed ten 5-s explosive maximal voluntary contractions for elbow and knee flexion and extension. The adults were stronger then the boys and the adult POW were stronger then the adult CON, even after correction for muscle size. Normalized rate of torque development was higher in the adults then in the boys and higher in the POW then CON boys. The rate of muscle activation was higher in the adults and POW groups. The results suggest that maturation and power-training have an additive effect on muscle activation.

The association between blood pressure and vascular characteristics in children

Hypertension is thought to exist in up to five percent of children. A select number of studies have investigated the role elevated blood pressure plays in pediatric atherosclerotic progression. However these studies contain significant methodological flaws and fail to recognize important confounding factors. Therefore, the influence of elevated blood pressure on arterial health in children remains to be clearly understood. The purpose of this study was to investigate the association between blood pressure (BP) and arterial thickness and stiffuess in children. Common carotid artery (CCA) intima-media thickness (IMT) and distensibility (Dist), as well as systemic pulse wave velocity (PWV) were measured in 21 elevated blood pressure (EBP; BP ~ 95th percentile) and 83 normal blood pressure (NBP; BP < 90th percentile) children 11-14 years of age. Both EBP and NBP groups demonstrated BP within the normal clinical range, but EBP showed significantly elevated BP as compared to the NBP group. Independent t-tests failed to show significant differences between the EBP and NBP groups for CCA IMT (0.43 ± 0.05 mm and 0.42 ± 0.06 mm, respectively) and Dist (0.0058 ± 0.0024 mmHg-1 and 0.0064 ± 0.0019 mmHil respectively). In contrast, a significantly elevated PWV (puess as measured through PWV. This may be the result of sympathetic predominance and its significant influence on the peripheral vasculature. More studies are needed to clearly illustrate the temporal sequence of pediatric atherosclerotic progression in response to elevated BP.

Transmission of West Nile virus in the Niagara Region among a population at risk for exposure

Background. West Nile Virus (WNV), a mosquito-borne flavivirus, is one of an increasing number of infectious diseases that have been emerging or re-emerging in the last two decades. Since the arrival ofWNV to Canada to present date, the Niagara Region has only reported 30 clinical cases, a small number compared to the hundreds reported in other regions of similar conditions. Moreover, the last reported human case in Niagara was in 2006. As it has been demonstrated that the majority of WNV infections are asymptomatic, the question remains whether the lack of clinical cases in Niagara truly reflects the lack of transmission to humans or if infections are still occurring but are mostly asymptomatic. Objectives. The general objective of this study was to establish whether or not active WNV transmission could be detected in a human population residing in Niagara for the 2007 transmission season. To fullfil this objective, a cross-sectional seroprevalence study was designed to investigate for the presence of anti-WNV antibodies in a sample of Mexican migrant agricultural workers employed in farms registered with the Seasonal Agricultural Workers Program (SAWP). Due to the Mexican origin of the study participants, three specific research objectives were proposed: a) determine the seroprevalence ofanti-WNV antibodies as well as anti-Dengue virus antibodies (a closely related virus prevalent in Mexico and likely to confound WNV serology); b) analyze risk factors associated with WNV and Dengue virus seropositivity; and c) assess the awareness of study participants about WNV infection as well as their understanding of the mode of transmission and clinical importance of the infection. Methodology: After obtaining ethics clearance from Brock University, farms were visited and workers invited to participate. Due to time constraints, only a small number of farms were enrolled with a resulting convenience and non-randomized study sample. Workers' demographic and epidemiological data were collected using a standardized questionnaire and blood samples were drawn to determine serum anti-WNV and anti- Dengue antibodies with a commercial ELISA. All positive samples were sent to the National Microbiology Laboratory in Winnipeg, Manitoba for confirmation with the Plaque Reduction Neutralization Test (PRNT). Data was analyzed with Stata 10.0. Antibody determinations were reported as seroprevalence proportions for both WNV and Dengue. Logistic regression was used to analyze risk factors that may be associated with seropositivity and awareness was reported as a proportion of the number of individuals possessing awareness over the total number of participants. Results and Discussion. In total 92 participants working in 5 farms completed the study. Using the commercial ELISA, seropositivity was as follows: 2.2% for WNV IgM, 20.7% for WNV IgG, and 17.1 % for Dengue IgG. Possible cross-reactivity was demonstrated in 15/20 (75.0%) samples that were positive for both WNV IgG and Dengue IgG. Confirmatory testing with the PRNT demonstrated that none of the WNV ELISA positive samples had antibodies to WNV but 13 samples tested positive for anti-Dengue antibodies (14.1 % Dengue sereoprevalence). The findings showed that the ELISA performance was very poor for assessing anti-WNV antibodies in individuals previously exposed to Dengue virus. However, the ELISA had better sensitivity and specificity for assessing anti-Dengue antibodies. Whereas statistical analysis could not be done for WNV seropositivity, as all samples were PRNT negative, logistic regression demonstrated several risk factors for Dengue exposure_ The first year coming to Canada appeared to be significantly associated with increased exposure to Dengue while lower socio-economic housing and the presence of a water basin in the yard in Mexico appeared to be significantly associated with a decreased exposure to Dengue_ These seemingly contradictory results illustrate that in mobile populations such as migrant workers, risk factors for exposure to Dengue are not easily identified and more research is needed. Assessing the awareness of WNV and its clinical importance showed that only 23% of participants had some knowledge of WNV, of which 76% knew that the infection was mosquito-borne and 47% recognized fever as a symptom. The identified lack of understanding and awareness was not surprising since WNV is not a visible disease in Mexico. Since WNV persists in an enzootic cycle in Niagara and the occurrence of future outbreaks is unpredictable, the agricultural workers remain at risk for transmission. Therefore it important they receive sufficient health education regarding WNV before leaving Mexico and during their stay in Canada. Conclusions. Human transmission of WNV could not be proven among the study participants even when due to their occupation they are at high risk for mosquito bites. The limitations of the study sample do not permit generalizable conclusions, however, the study findings are consistent with the absence of clinical cases in the Niagara Region, so it is likely that human transmission is indeed neglible or absent. As evidenced by our WNV serology results, PRNT must be utilized as a confirmatory test since false positivity occurs frequently. This is especially true when previous exposure to Dengue virus is likely.

Evaluation of a professional development curriculum in movement education and adapted physical activity for invisible disabilities : a critical cross-case analysis

Movement education and adapted physical activity are content areas not addressed in pre-service education or in-service training for Ontario practitioners working with individuals with disabilities in physical environments. Consequently, physical activity is often overlooked by service providers in programming and intervention for exceptional young learners. A formative evaluation, multiple-case study design was employed in this research in which a purposeful sample of expert practitioners performed a guided, descriptive evaluation of a three-day professional development workshop curriculum designed to supplement these areas lacking in professional preparation within their respective cohorts. Case-by-case and comparative analyses illustrated the inherent assumptions and societal constraints which prioritize the structure of professional development within the education system and other government organizations providing services for school-aged persons with disabilities in Ontario. Findings, discussed from a critical postmodern perspective, illustrate the paradoxical nature of Western values and prevailing mind/body dichotomy that guide professional practice in these fields.

The interpretation of environmental sustainability (ES) by the IOC/Olympic Games 1994-2008

The purpose of this qualitative multi-case study was to examine the interpretation of environmental sustainability (ES) within the Olympic 11 Movement. Two research questions guided the inquiry - first, how has the concept of ES been defined by the International Olympic Committee (lOC), and second, how has the concept of ES been defined and enacted by the Organizing Committees ofthe Olympic Games (OCOGs)? During the past two decades, the International Olympic Committee (lOC) established several policies and programs related to ES. Its actions reflect a broader trend of environmentalism within economic and social spheres around the world (Milton-Smith, 2002). Despite the numerous initiatives, the Olympic Games continue to cause significant environmental damage. Frey, et al. (2007) argued that the Olympic Movement contradicts the fundamental premises of ES because the Games are hosted in a two week time period, are situated in a confined area, and accumulate operating and infrastructure costs in the billions of dollars. Further, Etzion (2007) stated "there is positive and significant correlation between firm siz~ and environmental performance" (p. 642) and in the context of the Olympics the sizeimpact relation is striking. Since 1972, the year the UN launched its international environmental awareness efforts, the Summer Olympics grew to 201 nations (39% increase), 10,500 athletes (32% increase), 28 sports (30% increase), and 302 events (43% increase) (Johnson, 2004; Girginov & Parry, 2005; Upegui, 2008). The proliferation of Games activities counters the ES principles that exist within many of the IOC declarations, policies and programs.

A phenomenological approach to understanding the psychological response to chronic low back pain

Chronic low back pain (CLBP) is a complex health problem of psychological manifestations not fully understood. Using interpretive phenomenological analysis, 11 semi-structured interviews were conducted to help understand the meaning of the lived experience of CLBP; focusing on the psychological response to pain and the role of depression, catastrophizing, fear-avoidance behavior, anxiety and somatization. Participants characterized CLBP as persistent tolerable low back pain (TLBP) interrupted by periods of intolerable low back pain (ILBP). ILBP contributed to recurring bouts of helplessness, depression, frustration with the medical system and increased fear based on the perceived consequences of anticipated recurrences, all of which were mediated by the uncertainty of such pain. During times of TLBP all participants pursued a permanent pain consciousness as they felt susceptible to experience a recurrence. As CLBP progressed, participants felt they were living with a weakness, became isolated from those without CLBP and integrated pain into their self-concept.

Moving from values inaction to values-in-action : an exploration of how values can be managed intentionally by national sports organizations

The study examined the intentional use of National Sport Organizations' (NSOs) stated values. Positive Organizational Scholarship (POS) was applied to an Appreciative Inquiry (AI) approach of interviewing NSO senior leaders. One intention of this research was to foster a connection between academia and practitioners, and in so doing highlight the gap between values inaction and values-in-action. Data were collected from nine NSOs through multiple-case studies analysis of interview transcripts, websites, and constitutional statements. Results indicated that while the NSOs operated from a Management by Objectives (MBO) approach they were interested in exploring how Management by Values (MBV) might improve their organization's performance. Eleven themes from the case studies analysis contributed to the development of a framework. The 4-1 framework described how an NSO can progress through different stages by becoming more intentional in how they use their values. Another finding included deepening our understanding of how values are experienced within the NSO and then transferred across the entire sport. Participants also spoke about the tension that arises among their NSO' s values as well as the dominant values held by funding agents. This clash of values needs to be addressed before the tension escalates. Finally, participants expressed a desire to learn more about how values can be used more intentionally to further their organization's purpose. As such, strategies for intentionally leveraging values are also suggested. Further research should explore how helpful the 4-1 framework can be to NSOs leaders who are in the process of identifying or renewing their organization's values.

Leisure connections : a case study to understand facilitation techniques with survivors of trauma

Leisure-based therapy is a potentially effective approach to supporting survivors of trauma in their healing. The purpose ofthis qualitative case study was to describe the recreation therapist's facilitation techniques of Leisure Connections, a unique leisurebased psycho-educational group for survivors of trauma, and explore how the facilitation was experienced by participants. Qualitative case study design, following the methods of Yin (1994) was used. One two week, three session Leisure Connections group was observed. Six participants completed the Group· Therapy Alliance Scale (pinsof & Catherall, 1986) and reflection cards. In-depth, semi-structured interviews were conducted with the recreation therapist and four participants. Six themes emerged describing group leader interventions, recreation therapist's actions, recreation therapist's preparation and reflections, group members' experience of a therapeutic alliance, group cohesion, and prior influences and assumptions. Therapeutic alliance and group cohesion were influenced by the recreation therapist's group leader interventions (drawing out, processing, protecting) and actions. The context of the group within a therapeutic community milieu was an important influence.

The effects of upper extremity functional electrically stimulated (FES) exercise training on upper limb function in individuals with tetraplegia

Functional Electrically Stimulated (FES) ami cycle ergometry is a relatively new technique for exercise in individuals with impairments of the upper limbs. The purpose of this study was to determine the effects of 12 weeks of FES arm cycle ergometry on upper limb function and cardiovascular fitness in individuals with tetraplegia. F!ve subjects (4M/1F; mean age 43.8 ± 15.4 years) with a spinal cord injury of the cervical spine (C3- C7; ASIA B-D) participated in 12 weeks of3 times per week FES arm cycle ergometry training. Exercise performance measures (time to fatigue, distance to fatigue, work rate) were taken at baseline, 6 weeks, and following 12 weeks of training. Cardiovascular measures (MAP, resting HR, average and peak HR during exercise, cardiovascular efficiency) and self reported upper limb function (as determined by the CUE, sf-QIF, SCI-SET questionnaires) were taken at baseline and following 12 weeks of training. Increases were found in time to fatigue (84.4%), distance to fatigue (111.7%), and work rate (51.3%). These changes were non-significant. There was a significant decrease in MAP (91.1 ± 13.9 vs. 87.7 ± 14.7 mmHg) following 12 weeks ofFES arm cycle ergometry. There was no significant change in resting HR or average and peak HR during exercise. Cardiovascular efficiency showed an increase following the 12 weeks ofFES training (142.9%), which was non-significant. There were no significant changes in the measures of upper limb function and spasticity. Overall, FES arm cycle ergometry is an effective method of cardiovascular exercise for individuals with tetraplegia, as evidenced by a significant decrease in MAP, however it is unclear whether 12 weeks of thrice weekly FES arm cycle ergometry may effectively improve upper limb function in all individuals with a cervical SCI.

Association between adolescent leisure, peer social capital and academic performance among Canadian youth

Previous research shows discrepant findings between youth leisure programming (before and after school programs, structured summer program, day camp, overnight camp), academic performance and other youth developmental outcomes. Studies underscores the importance of family, community and school social capital in educational success of youth, investigation of peer social capital in the leisure context and academic performance outcomes is limited. This study uses a sample of 10 and 11 year olds (N=1764) from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) Cycle 6, to study the association between youth leisure programming, peer social capital and academic performance. Ordinal logistic regression models consistently showed a positive association between overnight camp and academic performance even after controlling for determinants of health, and measures of family, school and community social capital. Similarly, the measure of peer social capital was positively associated with academic performance. Most importantly, the interaction between overnight camp participation and peer social capital was significantly associated with academic performance. Study findings, highlight overnight camp opportunities and peer social

Opioid poisoning and availability of specialized medical care in Ontario, 2002-2006

The prescription of opioid analgesics has risen sharply in North America over the past two decades. This increase has been accompanied by a rise in overdoses. The present study draws on administrative data collected from emergency department contacts to describe the epidemiology of opioid overdose in Ontario b~tween 2002 and 2006 and to examine the role of regional variation in availability of specialist care. The number of poisonings increased from 1250 (10.9 per 100,000) in FY2002 to 1816 (15.2 per 100,000) in FY2005. Local concentration of specialist physicians was significantly associated with the incidence of opioid overdose, inversely at most levels of availability, but positively at very high levels. Regional variation in incidence was also associated with demographics, median family income, and the rate of other drug poisonings. Policy options for limiting opioid-related harms are limited, but improvements in monitoring and clinical management may prove valuable.

A Study of Nonfans and Fans of the National Lacrosse League's Edmonton Rush

The National Lacrosse League (NLL) is floundering. In an attempt to understand why NLL fans attend games and other sport fans do not, the NLL’s Edmonton Rush were studied. To best address the NLL’s attendance woes, two primary research questions were developed: 1) Why do fans of the Oilers and Oil Kings choose not to attend Edmonton Rush games? 2) Why do fans of the Edmonton Rush attend games? To answer these questions an online focus group along with a document analysis of Rush media, and a telephone interview were used to collect data. The data collection methods mentioned above assisted in answering the primary and secondary research questions, which allowed three major themes along with sub-themes to inductively emerge. The nonfans of the Rush do not attend Rush games because of the connection they have with hockey and the disconnection they have with lacrosse, some are simply not interested or were not entertained, as well as the lack of exposure the Rush receive. The Rush fan participants attend Rush games because of Edmonton community pride, the entertainment value they get out of attending a game, it is a great alternative new sport experience and it either is a substitute or a compliment to hockey. Both the nonfan and fan participants of this study believe that different marketing approaches can be utilized in order to attract nonfans to attend games.

Deception in Sport: A Conceptual and Ethical Analysis

In 1973, Kathleen Pearson offered a pivotal first step into understanding deception in competitive sport and its many intricacies. However, the analysis falls short of truly deciphering this widespread phenomenon. By creating a taxonomy based on Torres (2000) understanding of various types of skills in an athletic contest, a wider array of deceptive practices are encompassed. Once the taxonomy is put forth, weighing the categories against the three-pronged ethical permissibility test established utilizing elements from formalism, conventionalism and broad internalism sheds lights on what deceptive practices should be deemed ethically permissible for use and which tactics should not be a part of an athlete’s repertoire. By understanding which categories of deception are permissible, the most fair and athletically excellent contest can be created between the opposing players of teams.

Effects of age on learning a spatial motor task in younger and older adults individualizing their knowledge of results schedule

Self-controlled KR practice has revealed that providing participants the opportunity to control their KR is superior for motor learning compared to participants replicating the KR schedule of a self-control participant, without the choice (e.g., yoked). The purpose of the present experiment was two-fold. First, to examine the utility of a self-controlled KR schedule for learning a spatial motor task in younger and older adults and second, to determine whether a self-controlled KR schedule facilitates an increased ability to estimate one’s performance in retention and transfer. Twenty younger adults and 20 older adults practiced in either the self-control or yoked condition and were required to push and release a slide along a confined pathway using their non-dominant hand to a target distance. The retention data revealed that as a function of age, a self-controlled KR schedule facilitated superior retention performance and performance estimations in younger adults compared to their yoked counterparts.