Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa communiqué

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a 'roadmap' of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organisations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime.

Fetal umbilical artery Doppler pulsatility index and childhood neurocognitive outcome at 12 years

OBJECTIVE: To determine whether an elevated fetal umbilical artery Doppler (UAD) pulsatility index (PI) at 28 weeks' gestation, in the absence of fetal growth restriction (FGR) and prematurity, is associated with adverse neurocognitive outcome in children aged 12 years.

METHODS: Prospective cohort study, comparing children with a normal fetal UAD PI (<90th centile) (n=110) and those with an elevated PI (≥90th centile) (n=40). UAD was performed at 28, 32 and 34 weeks gestation. At 12 years of age, all children were assessed under standardised conditions at Queen's University, Belfast, UK to determine cognitive and behavioural outcomes using the British Ability Score-II and Achenbach Child Behavioural Checklist Parent Rated Version under standardised conditions. Regression analysis was performed, controlling for confounders such as gender, socioeconomic status and age at assessment.

RESULTS: The mean age of follow-up was 12.4 years (±0.5 SD) with 44% of children male (n=63). When UAD was assessed at 28 weeks, the elevated fetal UAD group had lower scores in cognitive assessments of information processing and memory. Parameters included (1) recall of objects immediate verbal (p=0.002), (2) delayed verbal (p=0.008) and (3) recall of objects immediate spatial (p=0.0016). There were no significant differences between the Doppler groups at 32 or 34 weeks' gestation.

CONCLUSIONS: An elevated UAD PI at 28 weeks' gestation in the absence of FGR or prematurity is associated with lower scores of declarative memory in children aged 12 years. A potential explanation for this is an element of placental insufficiency in the presence of the appropriately grown fetus, which affects the development of the fetal hippocampus and information processing and memory long-term. These findings, however, had no impact on overall academic ability, mental processing and reasoning or overall behavioural function.

A systematic review of evidence-based assessment practices by allied health practitioners for children with cerebral palsy

AIM: The routine use of psychometrically robust assessment tools is integral to best practice. This systematic review aims to determine the extent to which evidence-based assessment tools were used by allied health practitioners for children with cerebral palsy (CP).

METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols 2015 was employed. A search strategy applied the free text terms: 'allied health practitioner', 'assessment', and 'cerebral palsy', and related subject headings to seven databases. Included articles reported assessment practices of occupational therapists, physiotherapists, or speech pathologists working with children with CP aged 0 to 18 years, published from the year 2000.

RESULTS: Fourteen articles met the inclusion criteria. Eighty-eight assessment tools were reported, of which 23 were in high use. Of these, three tools focused on gross motor function and had acceptable validity for use with children with CP: Gross Motor Function Measure, Gross Motor Function Classification System, and goniometry. Validated tools to assess other activity components, participation, quality of life, and pain were used infrequently or not at all.

INTERPRETATION: Allied health practitioners used only a few of the available evidence-based assessment tools. Assessment findings in many areas considered important by children and families were rarely documented using validated assessment tools.

Improving allied health professionals' research implementation behaviours for children with cerebral palsy: protocol for a before-after study

BACKGROUND: Cerebral palsy is a permanent disorder of posture and movement caused by disturbances in the developing brain. It affects approximately 1 in every 500 children in developed countries and is the most common form of childhood physical disability. People with cerebral palsy may also have problems with speech, vision and hearing, intellectual difficulties and epilepsy. Health and therapy services are frequently required throughout life, and this care should be effective and evidence informed; however, accessing and adopting new research findings into day-to-day clinical practice is often delayed.

METHODS/DESIGN: This 3-year study employs a before and after design to evaluate if a multi-strategy intervention can improve research implementation among allied health professionals (AHPs) who work with children and young people with cerebral palsy and to establish if children's health outcomes can be improved by routine clinical assessment. The intervention comprises (1) knowledge brokering with AHPs, (2) access to an online research evidence library, (3) provision of negotiated evidence-based training and education, and (4) routine use of evidence-based measures with children and young people aged 3-18 years with cerebral palsy. The study is being implemented in four organisations, with a fifth organisation acting as a comparison site, across four Australian states. Effectiveness will be assessed using questionnaires completed by AHPs at baseline, 6, 12 and 24 months, and by monitoring the extent of use of evidence-based measures. Children's health outcomes will be evaluated by longitudinal analyses.

DISCUSSION: Government, policy makers and service providers all seek evidence-based information to support decision-making about how to distribute scarce resources, and families are seeking information to support intervention choices. This study will provide knowledge about what constitutes an efficient, evidence-informed service and which allied health interventions are implemented for children with cerebral palsy.

TRIAL REGISTRATION: Trial is not a controlled healthcare intervention and is not registered.

Developing Food Products For Consumers on a Gluten Free Diet

There is a significant increase in people that choose to follow an avoidance diet, especially excluding gluten. Unlike previously, there is now a demand for ‘no compromise’ gluten-free cereal products that have the same properties as their wheat contain counterparts. This is very challenging for the bakers and the cereal technologists due to the functional role of the gluten network in some of these products. Numerous combinations of raw materials form natural sources have been studied and critically evaluated in this review. Most of the gluten-free products are made of native and modified starches blended with different hydrocolloids due to their structure-building and water binding properties. These ingredients are added to a gluten-free flour, such as rice and corn. The legislation framework, formulations for manufacturing of highl nutritional value bread, pasta and cakes/biscuits as well as quality assurance aspects for the gluten-free manufacturers are discussed in this review.

L'effet du ludisme et de la propension à innover sur l'étendue de l'utilisation des systèmes de soutien a l'enseignement

Cette étude vise à identifier les caractéristiques des usagers qui les amèneraient à mieux utiliser ou à utiliser de façon plus innovatrice les technologies de l'information mises à leur disposition. Afin de répondre à cet objectif, nous étudierons, en particulier, le rôle de deux traits de personnalité (le ludisme informatique et la propension innover) comme facteurs qui influencent l’étendue de l’utilisation des logiciels de soutien à l'enseignement dans un environnement universitaire. De plus, ces traits de personnalité seront intégrés aux modèles actuels de l’acception et de l’utilisation des systèmes d’information.

(Dis)located Olympic Patriots: Sporting Connections, Administrative Communications and Imperial Ether in Interwar New Zealand

During the interwar period (1919–1939), protagonists of the early New Zealand Olympic Committee (NZOC) worked to renegotiate and improve the country's international sporting participation and involvement in the International Olympic Committee. To this end, NZOC effectively used its locally based administrators and well-placed expatriates in Britain to variously assert the organization's nascent autonomy, independence and political power, progress Antipodean athlete's causes and counter any potential doubt about the nation's peripheral position in imperial sporting dialogues. Adding to the corpus of scholarship on New Zealand's ties and tribulations with imperial Britain, both in and beyond sport (e.g. Beilharz and Cox, 2007, “Settler Capitalism Revisited,” Thesis Eleven 88: 112–124; Belich, 2001, Paradise Reforged: A History of the New Zealanders from the 1880s to the Year 2000, Auckland: Allen Lane; Belich, 2007, Making Peoples: A History of the New Zealanders from Polynesian Settlement to the End of the Nineteenth Century, Auckland: The Penguin Group; Coombes, 2006, Rethinking Settler Colonialism: History and Memory in Australia, Canada, Aotearoa New Zealand and South Africa, Manchester: Manchester University Press; MacLean, 2010, “New Zealand (Aotearoa),” In Routledge Companion to Sports History, edited by Steve W. Pope and John Nauright, 510–525, London: Routledge; Phillips, 1984, “Rugby, War and the Mythology of the New Zealand Male,” The New Zealand Journal of History 18 (1): 83–103; Phillips, 1987, A Man's Country: The Image of the Pakeha Male, Auckland: Penguin Books; Ryan, 2004, The Making of New Zealand Cricket, 1832–1914, London: Frank Cass; Ryan, 2005, Tackling Rugby Myths: Rugby and New Zealand Society 1854–2004, Dunedin: University of Otago Press; Ryan, 2007, “Sport in 19th-Century Aotearoa/New Zealand: Opportunities and Constraints,” In Sport in Aotearoa/New Zealand Society, edited by Chris Collins and Steve Jackson, 96–111, Auckland: Thomson), I will examine how the political actions and strategic location of three key NZOC agents (specifically, administrator Harry Amos and expatriates Arthur Porritt and Jack Lovelock) worked in their own particular ways to assert the position of the organization within the global Olympic fraternity. I argue that the efforts of Amos, Porritt and Lovelock also concomitantly served to remind Commonwealth sporting colleagues (namely Britain and Australia) that New Zealand could not be characterized as, or relegated to being, a distal, subdued or subservient colonial sporting partner. Subsequently, I contend that NZOC's development during the interwar period, and particularly the utility of expatriate agents, can be contextualized against historiographical shifts that encourage us to rethink, reimagine and rework narratives of empire, colonization, national identity, commonwealth and belonging.

Duo Geminiani and the Bach Ensemble, January 7, 1979

Concert program for Duo Geminiani and the Bach Ensemble, January 7, 1979

University Choir, Brass Choir and Madrigal Singers, April 17, 1962

Concert program for University Choir, Brass Choir and Madrigal Singers, April 17, 1962

The Guitar Ensemble May 11, 2002

Concert Program for The Guitar Ensemble May 11, 2002

Guitar Ensemble May 24, 2001

Concert Program for Guitar Ensemble May 24, 2001

Guitar Ensemble February 15, 2001

Concert Program for Guitar Ensemble February 15 2001

The Guitar Ensemble May 24, 2003

Concert Program for The Guitar Ensemble May 24 2003

The Guitar Ensemble February 8, 2003

Concert Program for The Guitar Ensemble February 8, 2003

Concert Program for Mallet Head Series, Mallet Jazz October 19, 2012

Concert Program