“I do like the activities which I can do…” Leisure participation experiences of children with movement impairments

Aim: To explore in depth the leisure participation experiences of children with movement impairments.

Methods: We used Interpretative Phenomenological Analysis approach to interpret and understand the experiences of 22 children with movement impairments, aged between 6 and 12?years. Children expressed their views through flexible child-centred methods of data collection that allowed the children to draw, paint, use stickers, and demonstrate their leisure activities and equipment while communicating about their experiences.

Results: Children participated in leisure activities of their choice, and expressed positive experience of fun, challenge, independence and achievement. The choice of activities depended on a combination of the motor functioning of the individual child, inspiration and support from families, friends and health professionals, as well as the possibility of adaptations and availability of community programmes. At times children felt disappointed and avoided some activities due to associated negative experience such as injury, fear, non-inclusion and the difficulty they had experienced in adapting and performing certain activities.

Conclusion: Families, therapists and community service providers such as disability organisations could enhance leisure participation experiences by suggesting and creating opportunities that could increase children’s choices of leisure activities.

• Implications for rehabilitation

• Children’s choice of activities, places and friends is important for positive experiences of fun, achievement, challenge, independence and motivation in leisure participation.

• Families and health professionals could assist children make appropriate choices for leisure activities that depends on factors such as motor abilities, adaptations and availability of activities in the community.

• In the community, widening the options for leisure activities such as non-competitive adaptive sports and indoor sports for children with variable levels of movement impairment could improve leisure participation experiences.

     

A Comparative Study of Mandibular Incisor Relation to the Lingual Frenum in Natural Dentition and in Complete Denture Wearers

The determination of the occlusal vertical dimension and proper positioning of the anterior teeth are major factors in making complete dentures which will give optimum service. In this study, efforts were made to evaluate the reliability of measurement of vertical distance between the anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors in natural dentition among different age groups and in complete denture wearers. Three hundred dentulous subjects belonging to different age groups and hundred edentulous patients wearing complete dentures were selected. The dentulous group was divided into three groups, group I (20–40 years), group II (41–60 years), group III (61 years and above) and the edentulous subjects being group IV ( 40–60 years). Mandibular irreversible hydrocolloid impression (Alginate) was made using modified stock tray. In edentulous subjects impression was made with denture in position. The vertical distance between anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors was measured on the dentulous casts and casts of complete denture wearer using dental surveyor and the vernier calipers. The values were tabulated and statistically analysed. The mean vertical distance between anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors among dentulous subjects was 12.3 mm and among complete denture wearers was found to be 13.2 mm. There was no significant variation in the mean vertical distance among dentulous subjects belonging to different age groups. At 5 % significance level, statistically there was a significant difference in the mean vertical distance between group I and group IV; group II and group IV.     

Acute idiopathic thrombocytopenic purpura in childhood: a case report

Acute thrombocytopenic purpura is the most common of thrombocytopenias of the childhood. Clinical features include petechial lesions on oral mucosa, gingival bleeding and occasionally hemorrhage. A case of acute thrombocytopenic purpura is presented.     

31P-MRS study of acetyl-L-carnitine treatment in geriatric depression: preliminary results

Objective:   This 12-week study of two elderly, depressed subjects investigated the effect of acetyl- L -carnitine (ALCAR) treatment on the Hamilton Depression Rating Scale (HDRS) and on measures of high-energy phosphate and membrane phospholipid metabolism.
Methods:   Two mildly depressed (HDRS 15–20), non-demented male subjects 70 and 80 years old were compared with six non-demented controls (all males, mean age of 73.6 ± 3.6 years). High-energy and membrane phospholipid metabolites were measured by phosphorus magnetic resonance spectroscopic imaging (³¹P MRSI) analysis. HDRS and ³¹P MRSI measurements were taken at entry, 6 and 12 weeks for the depressed subjects.
Results:   ³¹P MRSI analysis revealed elevated levels of phosphomonesters [PME( s  – τ_c)] in the prefrontal region of these mildly depressed subjects, which decreased with ALCAR treatment and showed a trend for correlation of the PME( s  – τ_c) levels with HDRS. ALCAR treatment also resulted in increasing levels of the prefrontal phosphocreatine (PCr), which correlated with HDRS.
Conclusions:   In the prefrontal region, the mildly depressed subjects compared with controls had elevated PME( s  – τ_c) levels which normalized after 12 weeks of ALCAR and increased PCr levels after ALCAR treatment. These preliminary findings suggest further studies are warranted.     

Fluvastatin potentiates the activity of caspofungin against Aspergillus fumigatus in vitro

Statins (anticholesterol drugs) inhibit HMG-CoA reductase, which is a key rate-limiting enzyme in the synthesis of sterols in fungi. We therefore investigated the in vitro inhibitory activity of various statins against Aspergillus fumigatus alone and in combination with antifungal drugs. Fresh conidial suspensions from 10 clinical isolates of A. fumigatus were obtained. The MIC and minimum fungicidal concentration (MFC) were determined by the Clinical and Laboratory Standards Institute M-38A protocol and the fungicidal activity by time–kill study. Fluvastatin (FST) showed good activity (MIC, 2 mg/L; MFC, 4 mg/L) against A. fumigatus; other statins had no activity (MIC ≥256 mg/L). FST enhanced the activity of caspofungin (CFG) against A. fumigatus; subinhibitory concentrations of FST in combination with CFG showed >99.9% killing of A. fumigatus conidia, whereas either drug alone showed poor activity at subinhibitory concentrations. FST potentiated the antifungal activity of CFG but displayed no specific interaction with voriconazole or amphotericin B.     

Routes to psychiatric inpatient care in an Inner London Borough

Summary A study is reported in which pathways to psychiatric inpatient care were investigated in an Inner London Borough. Data were collected on a series of 52 consecutive admissions of adults to the psychiatric wards serving the area. The most striking feature of the results was the variety of routes taken to inpatient care, combined with a high level of police involvement (23.1% of admissions) and low level of referral from General Practitioners (15.4% of admissions). Significant age differences in routes to care were found: those under 30 years were usually brought to hospital by the police or presented directly to psychiatric emergency services; those over 30 typically came via medical/surgical hospital services, domiciliary psychiatric services or psychiatric outpatients. There were no differences in the routes taken by Afro-Caribbean and white people or by men and women. Higher proportions of Afro-Caribbeans received a diagnosis of schizophrenia, considered themselves to have nothing wrong with them and were compulsorily detained. Higher proportions of whites were diagnosed as depressed and considered themselves to have physical problems rather than psychiatric ones. However, results clearly indicated that it was ethnic status rather than diagnostic category that accounted for the higher rates of compulsory detention of Afro-Caribbean people. The implications of the findings for service development and delivery are considered.     

Maternal adipose tissue response to nicotine administration in the pregnant rat: effects on fetal body fat and cellularity

Nicotine has been implicated as a causative factor in the intrauterine growth retardation associated with smoking in pregnancy. A study was set up to ascertain the effect of nicotine on fetal growth and whether this could be related to the actions of this drug on maternal adipose tissue metabolism. Sprague-Dawley rats were mated and assigned to control and nicotine groups, the latter receiving nicotine in the drinking-water throughout pregnancy. Animals were weighed at regular intervals and killed on day 20 of pregnancy. Rates of maternal adipose tissue lipolysis and lipogenesis were measured. Fetal and placental weights were recorded and analysis of fetal body water, fat, protein and DNA carried out. Weight gains of mothers in the nicotine group were less in the 1st and 2nd weeks of pregnancy, but similar to controls in the 3rd week. Fetal body-weights, DNA, protein and percentage water contents were similar in both groups. Mean fetal body fat (g/kg) was significantly higher in the nicotine group (96.2 (SE 5.1] compared with controls (72.0 (SE 2.9]. Rates of maternal lipolysis were also higher in the nicotine group. The cause of these differences and their effects on maternal and fetal well-being is discussed.     

Structure-activity relationships of substituted 1-pyridyl-2-phenyl-1,2-ethanediones: potent, selective carboxylesterase inhibitors

Inhibition of intestinal carboxylesterases may allow modification of the pharmacokinetics/pharmacodynamic profile of existing drugs by altering half-life or toxicity. Since previously identified diarylethane-1,2-dione inhibitors are decidedly hydrophobic, a modified dione scaffold was designed and elaborated into a >300 member library, which was subsequently screened to establish the SAR for esterase inhibition. This allowed the identification of single digit nanomolar hiCE inhibitors that showed improvement in selectivity and measured solubility.