Self-regulation (SR) is critical to healthy development in children, and intervention approaches (i.e., professional training, classroom-based curricula, parent-focused intervention) have shown to ...support or enhance SR. However, to our knowledge, none have tested whether changes in children's SR across an intervention relate to changes in children's health behavior and outcomes. This study, the Promoting Activity and Trajectories of Health (PATH) for Children-SR Study uses a cluster-randomized control trial to examine the immediate effects of a mastery-climate motor skills intervention on SR. Secondly, this study examines the associations between changes in SR and changes in children's health behaviors (i.e., motor competence, physical activity, and perceived competence) and outcomes (i.e., body mass index and waist circumference) (ClinicalTrials.gov Identifier, NCT03189862).
The PATH-SR study will be a cluster-randomized clinical trial. A total of 120 children between the ages of 3.5 to 5 years of age will be randomized to a mastery-climate motor skills intervention (n = 70) or control (n = 50) condition. SR will be assessed using measures that evaluate cognitive SR (cognitive flexibility and working memory), behavioral SR (behavioral inhibition), and emotional SR (emotional regulation). Health behaviors will be assessed with motor skills, physical activity, and perceived competence (motor and physical) and health outcomes will be waist circumference and body mass index. SR, health behaviors, and health outcomes will be assessed before and after the intervention (pre-test and post-test). Given the randomization design, 70 children in the intervention group and 50 in the control group, we have 80% power to detect an effect size of 0.52, at a Type I error level of 0.05. With the data collected, we will test the intervention effect on SR with a two-sample t-test comparing the intervention group and the control group. We will further evaluate the associations between changes in SR and changes in children's health behaviors and health outcomes, using mixed effect regression models, with a random effect to account for within-subject correlations. The PATH-SR study addresses gaps in pediatric exercise science and child development research. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development during the early years.
Ethical approval for this study was obtained through the Health Sciences and Behavioral Sciences Institutional Review Board, University of Michigan (HUM00133319). The PATH-SR study is funded by the National Institutes of Health Common Fund. Findings will be disseminated via print, online media, dissemination events and practitioner and/or research journals.
ClinicalTrials.gov Identifier, NCT03189862.
Promoting ball skills in preschool-age girls Veldman, Sanne L.C; Palmer, Kara K; Okely, Anthony D ...
Journal of science and medicine in sport,
01/2017, Letnik:
20, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Abstract Objectives Evidence supports that girls are less proficient than boys at performing ball skills. This study examined the immediate and long-term effects of a ball skill intervention on ...preschool-age girls’ ball skill performance. Design Randomized controlled trial. Methods Girls ( Mage = 47.24 ± 7.38 months) were randomly assigned to a high autonomy, mastery-based 9-week motor skill intervention (the Children's Health Activity Motor Program; CHAMP, 540 min; n = 38) or a control group (free-play; n = 16). Ball skill proficiency was assessed at pretest, posttest, and retention test (after 9 weeks) using the object control subscale of the Test of Gross Motor Development – 2nd Edition. Treatment efficacy was examined using linear mixed models. Two models were fit: one for short-term changes (pretest to posttest) and one for long-term changes (pretest to retention). Results Linear mixed models revealed a significantly time*treatment interaction for both models. Post hoc analysis confirmed that girls in CHAMP experienced significant gains in ball skills from pretest to posttest ( p < .001) and pretest to retention ( p < .001). Moreover, girls in CHAMP were no different from the control group at pretest ( p > .05) but had significantly higher ball skills scores at both posttest ( p < .001) and retention ( p < .001). Conclusions This study demonstrates the positive effects of a ball skill intervention (i.e., CHAMP) on improving girls’ ball skills both short- and long-term. Findings suggest that early childhood interventions that focus on the development of ball skills in young girls might be an avenue to improve girls’ ball skill performance.
Recently a commercial computer-controlled image analysis system (IAS) was introduced to measure automatically the diameters of inhibition zones in the agar diffusion test. However, there is little ...information on the precision of this method. In the present study clinical isolates of Salmonella spp. (N = 104), Escherichia coli (N = 100), Pasteurella spp. (N = 99), Actinobacillus pleuropneumoniae (N = 85), porcine streptococci (N = 100), and Staphylococcus aureus (N = 95) were tested in the agar diffusion test, using nineteen different antibiotics in tablets. All inhibition zone diameters were first measured by a laboratory technician and then by the IAS. Although the zone diameters of all bacteria-antibiotic combinations measured by the IAS and those measured by the laboratory technician showed a significant positive correlation, the size of the inhibition zone diameters measured by the technician and the IAS differed significantly in 59% of the combinations. However, these differences were very small and may have no clinical relevance. The IAS was also used to calculate minimum inhibitory concentrations (MIC values) from the zone diameters. In 82% of the bacteria-antibiotic combinations MIC values calculated by the IAS showed a significant positive correlation with MIC values obtained with the reference agar dilution test. However, in 92% of the bacteria-antibiotic combinations, the calculated MIC values differed significantly from the reference values. In some cases these differences were so large that they could be of clinical relevance. The IAS was unable to measure the diameter of inhibition zones of porcine streptococci properly, due to poor contrast. We concluded that when tablets are used as antibiotic carriers the IAS accurately measures the diameter of inhibition zones for bacteria species that give good contrast between the agar and bacterial growth. MIC values determined with the IAS were only indicative of those determined with the reference agar dilution test.
Aims and objectives
The aim of this study was to develop a valid and reliable instrument to assess the nurse‐child interaction during medical or nursing interventions.
Background
Communication is an ...important competency for the professional practice of nurses and physicians. The nurse‐patient relationship is fundamental for high‐quality care. It has been suggested that if nurses have more skills to interact with children, care will be less distressing and less painful for the children.
Design
A qualitative observational psychometric study; the GRRAS checklist was used.
Methods
In‐depth video‐analyses, taxonomy development (19 videos) and testing it is psychometric properties (10 videos). Three observers micro‐analysed video recordings of experienced nurses changing children's wound dressing in a specialised Burn Centre.
Results
The nurse‐child interaction taxonomy (NCIT) was developed to observe and score the interactional behaviour between nurse and child. The taxonomy has three main patterns: being considerate, attuning oneself, and procedural interventions, subdivided in eight dimensions. These dimensions contain 16 elements that can be observed and scored on a 7‐point scale. Intra‐rater, inter‐rater reliability and agreement were good.
Conclusions
This study shows that interaction between nurses and children can be assessed reliably with the NCIT by an experienced observer or alternatively, scoring by two observers is recommended.
Relevance to clinical practice
The development of the taxonomy is an important step to find evidence for the best way for nurses to interact with children during nursing interventions or medical events and as such, ultimately, contributes to providing the best care possible.
To present 6-month clinical outcomes from a series of 165 consecutive Descemet membrane endothelial keratoplasty (DMEK) procedures before and after the introduction of a novel stromal-sided S-stamp ...preparation technique that has decreased the incidence of iatrogenic primary graft failure by eliminating upside-down grafts.
Retrospective nonrandomized comparative case series.
We included 165 consecutive eyes that had undergone DMEK surgery for Fuchs' or pseudophakic bullous keratopathy. These cases were divided into 2 cohorts: the first cohort comprised 31 cases that used unstamped tissue before the S-stamp was introduced, and the second cohort comprised 133 cases after the S-stamp was incorporated into the standardized technique. A single unstamped DMEK case was performed after the introduction of the S-stamp for a total of 32 unstamped cases.
Donor materials were prepared at a single eye bank using a standardized technique, which subsequently incorporated the addition of a dry ink gentian violet S-stamp to the stromal side of Descemet membrane. All surgeries were performed at a single clinical site by 5 surgeons (2 attending surgeons and 3 fellows). Two of the 165 DMEK cases were performed for pseudophakic bullous keratopathy (2 cases, 1 in each cohort), and the remaining cases were for Fuchs' endothelial dystrophy. Primary outcome measures were assessed at 6 months and maintained in a prospective institutional review board-approved study.
We analyzed the 6-month endothelial cell density, incidence of iatrogenic primary graft failure, upside-down graft implantation, and rebubble events.
The S-stamp eliminated upside-down graft implantations (0/133 S-stamped vs 3/32 unstamped) and did not significantly alter 6-month endothelial cell loss (31±17% S-stamped vs 29±14% unstamped; P = 0.62) or frequency of rebubble (17/133 S-stamped vs 1/32 unstamped; P = 0.20).
The incorporation of a stromal-sided S-stamp eliminates iatrogenic primary graft failure owing to upside-down implantation of DMEK grafts, without adversely affecting early postoperative complications or 6-month endothelial cell loss.
Due to respiratory motion, accurate radiotherapy delivery to thoracic and abdominal tumors is challenging. We aimed to quantify the ability of mechanical ventilation to reduce respiratory motion, by ...measuring diaphragm motion magnitudes in the same volunteers during free breathing (FB), mechanically regularized breathing (RB) at 22 breaths per minute (brpm), variation in mean diaphragm position across multiple deep inspiration breath-holds (DIBH) and diaphragm drift during single prolonged breath-holds (PBH) in two MRI sessions.
In two sessions, MRIs were acquired from fifteen healthy volunteers who were trained to be mechanically ventilated non-invasively We measured diaphragm motion amplitudes during FB and RB, the inter-quartile range (IQR) of the variation in average diaphragm position from one measurement over five consecutive DIBHs, and diaphragm cranial drift velocities during single PBHs from inhalation (PIBH) and exhalation (PEBH) breath-holds.
RB significantly reduced the respiratory motion amplitude by 39%, from median (range) 20.9 (10.6-41.9) mm during FB to 12.8 (6.2-23.8) mm. The median IQR for variation in average diaphragm position over multiple DIBHs was 4.2 (1.0-23.6) mm. During single PIBHs with a median duration of 7.1 (2.0-11.1) minutes, the median diaphragm cranial drift velocity was 3.0 (0.4-6.5) mm/minute. For PEBH, the median duration was 5.8 (1.8-10.2) minutes with 4.4 (1.8-15.1) mm/minute diaphragm drift velocity.
Regularized breathing at a frequency of 22 brpm resulted in significantly smaller diaphragm motion amplitudes compared to free breathing. This would enable smaller treatment volumes in radiotherapy. Furthermore, prolonged breath-holding from inhalation and exhalation with median durations of six to seven minutes are feasible.
Medical Ethics Committee protocol NL.64693.018.18.
Repulsive guidance molecule A (RGMa) is a potent inhibitor of neuronal regeneration and a regulator of cell death, and it plays a role in multiple sclerosis (MS). In autopsy material from progressive ...MS patients, RGMa was found in active and chronic lesions, as well as in normal-appearing gray and white matter, and was expressed by cellular meningeal infiltrates. Levels of soluble RGMa in the cerebrospinal fluid were decreased in progressive MS patients successfully treated with intrathecal corticosteroid triamcinolone acetonide (TCA), showing functional improvements. In vitro, RGMa monoclonal antibodies (mAbs) reversed RGMa-mediated neurite outgrowth inhibition and chemorepulsion. In animal models of CNS damage and MS, RGMa antibody stimulated regeneration and remyelination of damaged nerve fibers, accelerated functional recovery, and protected the retinal nerve fiber layer as measured by clinically relevant optic coherence tomography. These data suggest that targeting RGMa is a promising strategy to improve functional recovery in MS patients.
Display omitted
•Decreased RGMa levels in MS patients correlate with functional improvements•Anti-RGMa treatment in an optic nerve crush model protects retinae•Anti-RGMa enhances regeneration after optic nerve crush and spinal cord inflammation•Animal models of multiple sclerosis show functional improvements after treatment
RGMa is a potent inhibitor of nerve growth and is expressed in several brain diseases, including Alzheimer’s disease and multiple sclerosis (MS). Demicheva et al. use an anti-RGMa-specific antibody in animal models of MS and show neural regeneration in the optic nerve after injury and in the spine after inflammation, accompanied by functional improvements.
Fundamental motor skills (FMS) contribute to positive health trajectories. A high level of competence in ball skills (a subset of FMS) is a predictor for time spent in moderate- to vigorous-intensity ...physical activity during adolescence. This study examined the effects of a ball skills intervention on ball skill competence among preschool-aged boys and girls.
This is a two-armed randomized controlled trial. A total of 124 preschoolers (Mage ± SD = 48.14 ± 6.62 months) were randomly assigned to one of two groups, the Children's Health Activity Motor Program (CHAMP; n = 81) or control (n = 43). FMS were measured before, after (9 wk), and at retention (18 wk) using the object control subscale of the Test of Gross Motor Development, Second Edition. Changes in ball skill scores were calculated (pretest-posttest, pretest-retention, posttest-retention) and were compared using one-way ANOVAs with post hoc Scheffe analysis.
Findings support that groups demonstrated significantly different rates of change from pretest to posttest (F3,117 = 179.45, P < 0.001), pretest to retention (F3,113 = 95.8, P < 0.001), and posttest to retention (F3,113 = 189.89, P < 0.001). Compared with their control group peers, CHAMP boys and girls had greater positive rates of change from pretest to posttest and pretest to retention as well as greater negative rates of change from posttest to retention.
CHAMP was effective in improving and maintaining ball skills in preschool-age boys and girls. Findings support that providing a high-quality motor skill program in early childhood settings could potentially be a sustainable public health approach to promoting FMS and positive developmental trajectories for health.
Purpose
Sensory input can modify voluntary motor function. We examined whether somatosensory electrical stimulation (SES) added to motor practice (MP) could augment motor learning, interlimb ...transfer, and whether physiological changes in neuronal excitability underlie these changes.
Methods
Participants (18–30 years,
n
= 31) received MP, SES, MP + SES, or a control intervention. Visuomotor practice included 300 trials for 25 min with the right-dominant wrist and SES consisted of weak electrical stimulation of the radial and median nerves above the elbow. Single- and double-pulse transcranial magnetic stimulation (TMS) metrics were measured in the intervention and non-intervention extensor carpi radialis.
Results
There was 27 % motor learning and 9 % (both
p
< 0.001) interlimb transfer in all groups but SES added to MP did not augment learning and transfer. Corticospinal excitability increased after MP and SES when measured at rest but it increased after MP and decreased after SES when measured during contraction. No changes occurred in intracortical inhibition and facilitation. MP did not affect the TMS metrics in the transfer hand. In contrast, corticospinal excitability strongly increased after SES with MP + SES showing sharply opposite of these effects.
Conclusion
Motor practice and SES each can produce motor learning and interlimb transfer and are likely to be mediated by different mechanisms. The results provide insight into the physiological mechanisms underlying the effects of MP and SES on motor learning and cortical plasticity and show that these mechanisms are likely to be different for the trained and stimulated motor cortex and the non-trained and non-stimulated motor cortex.
Repulsive guidance molecule A (RGMa) is a potent inhibitor of axonal growth and a regulator of neuronal cell death. It is up-regulated following neuronal injury and accumulates in chronic ...neurodegenerative diseases. Neutralizing RGMa has the potential to promote neuroregeneration and neuroprotection. Previously we reported that a rat anti-N terminal RGMa (N-RGMa) antibody r5F9 and its humanized version h5F9 (ABT-207) promote neuroprotection and neuroregeneration in preclinical neurodegenerative disease models. However, due to its cross-reactivity to RGMc/hemojuvelin, ABT-207 causes iron accumulation in vivo, which could present a safety liability. Here we report the generation and characterization of a novel RGMa-selective anti-N-RGMa antibody elezanumab, which is currently under Phase 2 clinical evaluation in multiple disease indications. Elezanumab, a human monoclonal antibody generated by in vitro PROfusion mRNA display technology, competes with ABT-207 in binding to N-RGMa but lacks RGMc cross-reactivity with no impact on iron metabolism. It neutralizes repulsive activity of soluble RGMa in vitro and blocks membrane RGMa mediated BMP signaling. In the optic nerve crush and optic neuritis models, elezanumab promotes axonal regeneration and prevents retinal nerve fiber layer degeneration. In the spinal targeted experimental autoimmune encephalomyelitis (EAE) model, elezanumab promotes axonal regeneration and remyelination, decreases inflammatory lesion area and improves functional recovery. Finally, in the mouse cuprizone model, elezanumab reduces demyelination, which is consistent with its inhibitory effect on BMP signaling. Taken together, these preclinical data demonstrate that elezanumab has neuroregenerative and neuroprotective activities without impact on iron metabolism, thus providing a compelling rationale for its clinical development in neurodegenerative diseases.
•Elezanumab binds N-terminal RGMa, blocks BMP signaling and lacks RGMc cross-reactivity with no impact on iron metabolism•Elezanumab promotes axonal regeneration and prevents RNFL degeneration in optic nerve crush and neuritis models•Elezanumab promotes axonal regeneration and improves functional recovery in a spinal tEAE model•Elezanumab reduces demyelination in a cuprizone-induced demyelination model
PDF
