Effect of Community-Based Functional Aerobic Training on Motor Performance and Quality of Life of Children with Spastic Cerebral Palsy

BackgroundEfficacies of community-based exercise programmes have been well reported but there is scarce information on the expediency of community-based rehabilitation in a society where many of children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. The study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP).MethodsQuasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I – II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40–80% maximum heart rate. Gross motor function (GMF), walk distance and quality of life were assessed pre and post CBFAE training.ResultsSignificant improvement observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking+running+jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in Pain and impact of disability (67.93%, P=.049) and Participation and physical health (60.00%, P=.042).ConclusionCBFAE training contributes majorly to improved standing, walking, jumping and running and selfesteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances.     

Using objective structured clinical examinations to meet clinical competence evaluation challenges with distance education students

PURPOSE. This study aims to describe the use of modified objective structured clinical examinations (OSCEs) developed to address the identified educational need for formative advanced practice psychiatric mental health (PMH) student assessments and focused learning experiences within a modified nursing distance education program that serves advanced practice nurse PMH students from rural/underserved areas. CONCLUSION. OSCEs represent a practical solution to the challenges of clinical competency evaluation in psychiatric nursing distance education programs. PRACTICE IMPLICATIONS. OSCEs add a supportive evaluation layer to the precepted experience. This increases the availability of PMH nurse practitioner/clinical nurse specialist distance education programs focused on improving advanced PMH nursing services in rural and underserved areas.     

Neuroimaging and Inferential Distance

Brain images are used both as scientific evidence and to illustrate the results of neuroimaging experiments. These images are apt to be viewed as photographs of brain activity, and in so viewing them people are prone to assume that they share the evidential characteristics of photographs. Photographs are epistemically compelling, and have a number of characteristics that underlie what I call their inferential proximity. Here I explore the aptness of the photography analogy, and argue that although neuroimaging does bear important similarities to photography, the details of the generation and analysis of neuroimages significantly complicate the relation of the image to the data. Neuroimages are not inferentially proximate, but their seeming so increases the potential for misinterpretation. This suggests caution in appealing to such images in the public domain.

山东省烟台和威海地区汉族HLA-A、B和DRB1等位基因多态性及遗传距离分析

目的 分析山东省烟台和威海地区汉族人群人类白细胞抗原(human leukocyte antigen,HLA)-A、B、DRB1等位基因的多态性分布特征,并探讨该人群与其他人群的亲缘关系.方法 应用聚合酶链反应-序列特异性寡核苷酸探针方法(polymerase chain reaction-sequence specific olignucleotide probe,PCR-SSOP)对山东省烟台和威海地区4062名无亲缘关系的汉族健康个体进行HLA-A、B、DRB1基因分型.采用Arlequin3.5软件计算HLA等位基因频率、单倍型频率和连锁不平衡参数,按内氏公式计算出不同人群之间的遗传距离,并利用Mega5.0软件构建系统发生树.结果 该人群HLA-A、B、DRB1等位基因分布均符合Hardy-Weinberg平衡(P＞0.1).3个基因座分别检出18、33和13个等位基因,其中等位基因频率分布最高的分别是A* 02 (0.2935)、B* 15 (0.1485)和DRB1* 15 (0.1621);最常见的单倍型为A* 30-B* 13-DRB1* 07(0.0649),A* 33-B* 58、A*66-DRB1* 13、B*08-DRB1* 03呈现最强的连锁不平衡;山东省烟台和威海汉族人群与吉林省汉族人群遗传距离最小,为0.0034.结论 山东省烟台和威海地区汉族人群HLA-A、B、DRB1等位基因和单倍型具有较高的遗传多态性,该人群与吉林汉族人群亲缘关系最近.     

自我-他人医疗决策差异研究

目的:考察医疗情境中,自我决策与为他人提供建议是否存在决策偏差,并基于解释水平的理论,解释这种偏差的由来。方法:改编Ficchhoff等使用过的医疗决策问题,分别以正/负框架(2)×自我/他人(2)进行描述。355名临床专业大学生被随机分为四组完成决策任务。结果:社会距离对医疗决策影响显著(χ2=8.636,P=0.003),自我决策与向他人建议相比,被试更倾向短期获益,长期受损的保守方案。框架效应对医疗决策影响显著(χ2=9.804,P=0.002),正性框架相比负性框架,被试更倾向短期受损,长期获益的手术方案。解释水平与框架效应交互作用显著:正性框架中,自我-他人决策差异显著(χ2=12.309,P<0.001),自我决策更倾向手术方案,负性框架中,自我-他人决策无显著差异(χ2=0.706,P=0.401);自我决策中,框架效应不显著(χ2=0.91,P=0.340),向他人建议,框架效应显著(χ2=13.256,P<0.001)。结论:社会距离与框架描述对医疗决策存在影响。     

Malaria parasitaemia among long distance truck drivers in the Niger delta of Nigeria

Background

Malaria is the leading cause of morbidity and mortality in sub-Saharan Africa.

Objective

The aim of this study was to determine the prevalence of malaria among long distance truck drivers in the Niger Delta of Nigeria.

Methods

A total of one hundred consecutively recruited long distance truck drivers aged 21–60 years, with a mean age of 42.36 ± 5.23 years were screened for the presence of malaria parasitaemia.

Results

Out of the 100 truck drivers screened, 35 (35%) were positive for malaria while 65 (65%) were negative. Plasmodium falciparum was responsible for all cases of malaria infection. The highest prevalence of malaria occurred among drivers in the 51–60 years age group (40.5%). The mean and standard deviation (SD) of parasite load was 1 020 (125) parasites/ìl in subjects positive for malaria. The mean CD4 count was significantly higher among non-parasitized truck drivers compared to P. falciparum parasitized drivers 820 ± 42.0 (731–902 cells/ µl) and 570 ± 30.0 (510–630 cells/ µl) respectively (chi square = 74.00; p = 0.03). We observed a significant negative correlation between plasmodial infection and CD4 lymphocyte count among Plasmodium falciparum-infected subjects with r = − 0.56 (p= 0.001).

Conclusion

Preventative strategies including regular chemoprophylaxis, intermittent preventive treatment with antimalarials and provision of insecticide-treated bed nets should be implemented.     

Retinotopic mapping of the peripheral visual field to human visual cortex by functional magnetic resonance imaging

Retinotopic mapping is a key property of organization in the human occipital cortex. The retinotopic organization of the central visual field of visual areas V1, V2, and V3 has been well established. We used fMRI to measure the retinotopic map of the peripheral visual field (eccentricity up to 60°). We estimated the sizes of the visual areas between 0° and 60° and obtained results consistent with anatomical studies. We also estimated the cortical distances and magnification factors for reconstruction of the retinotopic map using the peripheral wedge dipole model. By comparing the retinotopic map with the flattened surface, we analyzed the datasets used to reconstruct the map. We found that: (1) the percentage of the striate cortex devoted to peripheral vision in humans is significantly larger than that in the macaque, (2) the estimate of the scaling factor in linear magnification is larger than that found in previous studies focusing on central vision, and (3) the estimate of the peripheral factor in the dipolar model is too large to make the curve direction of the dipolar map in the periphery equivalent to that in the center. On the basis of our results, we revised the dipolar map to fit our conditions. The revised map in humans has a similar elliptical shape to that of macaques, and the central parts of the two species are the same. The different parts of the map are the peripheral regions, for which the peripheral wedge dipole model in humans is reversed compared to that of macaques.