A randomized controlled trial of the impact of therapeutic horse riding on the quality of life, health, and function of children with cerebral palsy

This randomized controlled trial examined whether therapeutic horse riding has a clinically significant impact on the physical function, health and quality of life (QoL) of children with cerebral palsy (CP). Ninety-nine children aged 4 to 12 years with no prior horse riding experience and various levels of impairment (Gross Motor Function Classification System Levels I-III) were randomized to intervention (10wks therapeutic programme; 26 males, 24 females; mean age 7y 8mo [SD 2y 5mo] or control (usual activities, 27 males, 22 females; mean age 8y 2mo [SD 2y 6mo]). Pre- and post-measures were completed by 72 families (35 intervention and 37 control). Children's gross motor function (Gross Motor Function Measure [GMFM]), health status (Child Health Questionnaire [CHQ]), and QoL (CP QoL-Child, KIDSCREEN) were assessed by parents and QoL was assessed by children before and after the 10-week study period. On analysis of covariance, there was no statistically significant difference in GMFM, CP QoL-Child (parent report and child self-report), and CHQ scores (except family cohesion) between the intervention and control group after the 10-week study period, but there was weak evidence of a difference for KIDSCREEN (parent report). This study suggests that therapeutic horse riding does not have a clinically significant impact on children with CP. However, a smaller effect cannot be ruled out and the absence of evidence might be explained by a lack of sensitivity of the instruments since the QoL and health measures have not yet been demonstrated to be sensitive to change for children with CP.

Molecular detection of exercise-induced free radicals following ascorbate prophylaxis in type 1 diabetes mellitus: a randomised controlled trial

AIMS/HYPOTHESIS

Patients with type 1 diabetes mellitus are more susceptible than healthy individuals to exercise-induced oxidative stress and vascular endothelial dysfunction, which has important implications for the progression of disease. Thus, in the present study, we designed a randomised double-blind, placebo-controlled trial to test the original hypothesis that oral prophylaxis with vitamin C attenuates rest and exercise-induced free radical-mediated lipid peroxidation in type 1 diabetes mellitus.

METHODS

All data were collected from hospitalised diabetic patients. The electron paramagnetic resonance spectroscopic detection of spin-trapped alpha-phenyl-tert-butylnitrone (PBN) adducts was combined with the use of supporting markers of lipid peroxidation and non-enzymatic antioxidants to assess exercise-induced oxidative stress in male patients with type 1 diabetes (HbA(1c) 7.9 +/- 1%, n = 12) and healthy controls (HbA(1c) 4.6 +/- 0.5%, n = 14). Following participant randomisation using numbers in a sealed envelope, venous blood samples were obtained at rest, after a maximal exercise challenge and before and 2 h after oral ingestion of 1 g ascorbate or placebo. Participants and lead investigators were blinded to the administration of either placebo or ascorbate treatments. Primary outcome was the difference in changes in free radicals following ascorbate ingestion.

RESULTS

Six diabetic patients and seven healthy control participants were randomised to each of the placebo and ascorbate groups. Diabetic patients (n = 12) exhibited an elevated concentration of PBN adducts (p < 0.05 vs healthy, n = 14), which were confirmed as secondary, lipid-derived oxygen-centred alkoxyl (RO.) radicals (a(nitrogen) = 1.37 mT and abeta(hydrogen) = 0.18 mT). Lipid hydroperoxides were also selectively elevated and associated with a depression of retinol and lycopene (p < 0.05 vs healthy). Vitamin C supplementation increased plasma vitamin C concentration to a similar degree in both groups (p < 0.05 vs pre-supplementation) and attenuated the exercise-induced oxidative stress response (p < 0.05 vs healthy). There were no selective treatment differences between groups in the primary outcome variable.

CONCLUSIONS/INTERPRETATION

These findings are the first to suggest that oral vitamin C supplementation provides an effective prophylaxis against exercise-induced free radical-mediated lipid peroxidation in human diabetic blood.

CLINICAL TRIALS REGISTRATION NUMBER

ISRCTN96164937.

The relationship between proxy reported health-related quality of life and parental distress: gender differences

OBJECTIVE

Although primary caregiver proxy reports of health-related quality of life (HRQOL) are often used for healthcare decision making when child self-reports are unable to be collected (because of a variety of reasons such as child illness, disability or age), we have little understanding of the correlates of parent-proxy reports. The aim of this study was to examine the relationship between parental depression and parent-proxy reported QOL for primary caregivers (mothers and fathers), using a multidimensional HRQOL instrument. It was hypothesized that maternal depression would be negatively correlated with maternal reported HRQOL, but that paternal depression would not be correlated with paternal reported HRQOL.

METHODS

Data were from parents of children aged 4-5 years (n = 4983) involved in the Longitudinal Study of Australian Children. A questionnaire assessing parental depression (Kessler-6) and proxy reported HRQOL (Pediatric Quality of Life Inventory) was completed by the primary caregiver.

RESULTS

For maternal primary caregivers, maternal depression was negatively correlated with all domains of maternal proxy reports of HRQOL (r = -0.24 to r = -0.36). For paternal primary caregivers, there was no relationship between paternal depression and paternal proxy reports of HRQOL. Multiple regression analyses demonstrated that maternal depression was a significant predictor of total HRQOL, accounting for 12% of the variance. For paternal mental health, depression did not predict parent-proxy reported total HRQOL.

CONCLUSION

These results highlight the importance of assessing maternal mental health when measuring proxy reported QOL. Further research is needed in this area to examine the relationship between parental depression and proxy reported HRQOL (including both mothers and fathers, where possible), as well as child self-reported HRQOL.

Discrepancy between expected and actual child support payments: predicting the health and health-related quality of life of children living in low-income, single-parent families

OBJECTIVE

Although the amount and frequency of child support payments received by single parents are often erratic and fluctuate, no study to date has quantitatively explored how the discrepancy between expected and actual payments relates to child health. This study aims to examine whether the discrepancy between expected and actual child support payments predicts a range of child health outcomes, including global health, health-related quality of life, involvement in activities and parental psychological distress.

METHODS

This study used results from the Longitudinal Study of Australian Children, which included a sample of parents of children aged 4-5 years (n = 4983). The questionnaire was completed by the parent who spent the most time with the child and knew the child best. From the 4983 families, 332 low-income single parents reliant on welfare with a formal or informal child support order in place were identified.

RESULTS

After controlling for income, the discrepancy between expected and actual child support predicted school functioning, conduct problems, total mental health problems and involvement in activities. Discrepancy between expected and actual child support payments did not predict the remaining health-related quality of life domains, mental health domains, global child health or parental psychosocial distress.

CONCLUSION

This was the first study to examine how the discrepancy between expected and actual child support payments relates to child health, providing important data on the effectiveness of the child support system for children's well-being. These findings highlight the potential impact of the discrepancy on school functioning, conduct problems, total mental health problems and involvement in activities.

Getting the complete picture: combining parental and child data to identify the barriers to social inclusion for children living in low socio-economic areas

BACKGROUND

Childhood mental health problems are prevalent in Australian children (14-20%). Social exclusion is a risk factor for mental health problems, whereas being socially included can have protective effects. This study aims to identify the barriers to social inclusion for children aged 9-12 years living in low socio-economic status (SES) areas, using both child-report and parent-report interviews.

METHODS

Australian-born English-speaking parents and children aged 9-12 years were sampled from a low SES area to participate in semi-structured interviews. Parents and children were asked questions around three prominent themes of social exclusion; exclusion from school, social activities and social networks.

RESULTS

Many children experienced social exclusion at school, from social activities or within social networks. Overall, nine key barriers to social inclusion were identified through parent and child interviews, such as inability to attend school camps and participate in school activities, bullying and being left out, time and transport constraints, financial constraints and safety and traffic concerns. Parents and children often identified different barriers.

DISCUSSION

There are several barriers to social inclusion for children living in low SES communities, many of which can be used to facilitate mental health promotion programmes. Given that parents and children may report different barriers, it is important to seek both perspectives.

CONCLUSION

This study strengthens the evidence base for the investments and action required to bring about the conditions for social inclusion for children living in low SES communities.

Further mechanical considerations between polar and SRM mobile ergometer systems during laboratory-based high-intensity, intermittent cycling activity

The purpose of this article is to outline mechanical issues related to the use of the Polar S710 heart monitor with Power Unit when compared with the SRM Powercrank system. There are issues outlined in this article that refer to the suitability of the Polar S710 for the quantification of performance during downhill cycling that relate to chain vibration, chain tension, and time interval sampling rates.

Stimulation by means of dendritic cells followed by Epstein-Barr virus-transformed B cells as antigen-presenting cells is more efficient than dendritic cells alone in inducing Aspergillus f16-specific cytotoxic T cell responses

Adoptive immunotherapy with in vitro expanded antigen-specific cytotoxic T lymphocytes (CTLs) may be an effective approach to prevent, or even treat, Aspergillus (Asp) infections. Such lines can be generated using monocyte-derived dendritic cells (DC) as antigen-presenting cells (APC) but requires a relatively high volume of starting blood. Here we describe a method that generates Asp-specific CTL responses more efficiently using a protocol of antigen presented on DC followed by Epstein-Barr virus (EBV)-transformed B lymphoblastoid cell lines (BLCL) as APC. Peripheral blood mononuclear cells were stimulated weekly (2-5x) with a complete pool of pentadecapeptides (PPC) spanning the coding region of Asp f16 pulsed onto autologous mature DC. Cultures were split and stimulated subsequently with either PPC-DC or autologous PPC-pulsed BLCL (PPC-BLCL). Lines from the DC/BLCL arm demonstrated Asp f16-specific cytotoxicity earlier and to a higher degree than lines generated with PPC-DC alone. The DC/BLCL-primed lines showed a higher frequency of Asp f16-specific interferon (IFN)-gamma producing cells but an identical effector cell phenotype and peptide specificity compared to PPC-DC-only-primed lines. Tumour necrosis factor (TNF)-alpha, but not IL-10, appeared to play a role in the effectiveness of BLCL as APC. These results demonstrate that BLCL serve as highly effective APC for the stimulation of Asp f16-specific T cell responses and that a culture approach using initial priming with PPC-DC followed by PPC-BLCL may be a more effective method to generate Asp f16-specific T cell lines and requires less starting blood than priming with PPC-DC alone.

Search for production of single top quarks via tcg and tug flavor-changing-neutral-current couplings

We search for the production of single top quarks via flavor-changing-neutral-current couplings of a gluon to the top quark and a charm (c) or up (u) quark. We analyze 230 pb{-1} of lepton+jets data from pp[over] collisions at a center of mass energy of 1.96 TeV collected by the D0 detector at the Fermilab Tevatron Collider. We observe no significant deviation from standard model predictions, and hence set upper limits on the anomalous coupling parameters kappa{g}{c}/Lambda and kappa{g}{u}/Lambda, where kappa{g} define the strength of tcg and tug couplings, and Lambda defines the scale of new physics. The limits at 95% C.L. are kappa{g}{c}/Lambda<0.15 TeV-1 and kappa{g}{u}/Lambda<0.037 TeV-1.

AKR1B7 (mouse vas deferens protein) is dispensable for mouse development and reproductive success

AKR1B7 (aldo-keto reductase family 1, member 7; also known as mouse vas deferens protein) is a member of the AKR superfamily, and has been suggested to play a role in detoxifying processes on account of its preferred substrates, 4-hydroxynonenal and isocaproaldehyde. High levels of protein expression were found in the vas deferens and the adrenal gland, where sustained expression is dependent on androgen or ACTH respectively. Recently, a remarkable induction of AKR1B7 expression has been reported in the ovary following exogenous injections of LH. In the present study, we confirm this regulation physiologically during the estrous cycle, observing Akr1b7 expression to be restricted to the theca and stromal cells of the proestrus ovary. To further investigate the role of this detoxifying enzyme in both male and female reproduction, we generated knockout mice deficient in AKR1B7. Although AKR1B7 expression in the vas deferens is considerable and tightly regulated in the ovary of wild-type animals, homozygous mutant animals were found to be viable and no reproductive phenotype was observed. Ovarian follicle maturation and spermatozoa parameters remained normal in the absence of this protein. The determination of serum progesterone revealed an increase in hormone concentration in metestrus, while progesterone was found to be decreased in the estrus phase of the cycle in knockout females.

Search for techniparticles in e+jets events at D0

We search for the technicolor process pp-->rhoT/omegaT-->WpiT in events containing one electron and two jets, in data corresponding to an integrated luminosity of 390 pb(-1), recorded by the D0 experiment at the Fermilab Tevatron. Technicolor predicts that technipions pi(T) decay dominantly into bb, bc, or bc, depending on their charge. In these events b and c quarks are identified by their secondary decay vertices within jets. Two analysis methods based on topological variables are presented. Since no excess above the standard model prediction was found, the result is presented as an exclusion in the pi(T) vs rho(T) mass plane for a given set of model parameters.

Evidence for production of single top quarks and first direct measurement of |Vtb|

The D0 Collaboration presents first evidence for the production of single top quarks at the Fermilab Tevatron pp[over ] collider. Using a 0.9 fb(-1) dataset, we apply a multivariate analysis to separate signal from background and measure sigma(pp[over ]-->tb+X,tqb+X)=4.9+/-1.4 pb. The probability to measure a cross section at this value or higher in the absence of a signal is 0.035%, corresponding to a 3.4 standard deviation significance. We use the cross section measurement to directly determine the Cabibbo-Kobayashi-Maskawa matrix element that describes the Wtb coupling and find 0.68<|V(tb)|</=1 at 95% C.L. within the standard model.

Measurement of the charge asymmetry in semileptonic Bs0 decays

We have performed the first direct measurement of the time-integrated flavor untagged charge asymmetry in semileptonic Bs0 decays ASLs,unt by comparing the decay rate of Bs0-->micro+Ds-nuX, where Ds- -->phipi- and phi-->K+K-, with the charge-conjugate Bs0 decay rate. This sample was selected from 1.3 fb-1 of data collected by the D0 experiment in run II of the Fermilab Tevatron collider. We obtain ASLs,unt=[1.23+/-0.97(stat)+/-0.17(syst)]x10(-2). Assuming that Deltam(s)/Gamma(s)>>1, this result can be translated into a measurement of the CP-violating phase in Bs0 mixing: DeltaGamma(s)/Deltam(s)tanphi(s)=[2.45+/-1.93(stat)+/-0.35(syst)]x10(-2).

Lifetime difference and CP-violating phase in the Bs0 system

From an analysis of the decay Bs0-->J/psi phi, we obtain the width difference between the light and heavy mass eigenstates DeltaGamma identical with (GammaL-GammaH)=0.17+/-0.09(stat)+/-0.02(syst) ps-1 and the CP-violating phase phis=-0.79+/-0.56(stat)(-0.01)(+0.14)(syst). Under the hypothesis of no CP violation (phis identical with 0), we obtain 1/Gamma=tau(Bs0)=1.52+/-0.08(stat)(-0.03)(+0.01)(syst) ps and DeltaGamma=0.12(-0.10)(+0.08)(stat)+/-0.02(syst) ps-1. The data sample corresponds to an integrated luminosity of about 1.1 fb-1 accumulated with the D0 detector at the Fermilab Tevatron collider. This is the first direct measurement of the CP-violating mixing phase in the Bs0 system.

Experimental discrimination between charge 2e/3 top quark and charge 4e/3 exotic quark production scenarios

We present the first experimental discrimination between the 2e/3 and 4e/3 top quark electric charge scenarios, using top quark pairs (tt) produced in pp collisions at (square root) s = 1.96 TeV by the Fermilab Tevatron Collider. We use 370 pb;{-1} of data collected by the D0 experiment and select events with at least one high transverse momentum electron or muon, high transverse energy imbalance, and four or more jets. We discriminate between b- and b-quark jets by using the charge and momenta of tracks within the jet cones. The data are consistent with the expected electric charge, |q|=2e/3. We exclude, at the 92% C.L., that the sample is solely due to the production of exotic quark pairs QQ with |q|=4e/3. We place an upper limit on the fraction of QQ pairs rho<0.80 at the 90% C.L.

Effect of age and gender on the pharmacokinetics of R667, a novel agent for the treatment of emphysema, in healthy volunteers

The purpose of the present study was to assess the impact of age and gender on the pharmacokinetics (PK) of R667. Thirty six healthy male and female volunteers (12 m 18-45 years; 12 m and 12 f > or = 65 years) received a single 1 mg oral dose of R667. Serial blood samples were collected for determination of plasma R667 and metabolite concentrations. The PK parameters of R667 were similar between elderly males and young males (Cmax = 9.8 vs 9.8 ng/mL; AUC(0-last) = 50.9 vs 47.3 ng x h/mL, respectively). Exposure of R667 increased in elderly females compared to elderly males (Cmax = 13.1 vs 9.8 ng/mL; AUC(0-last) = 60.8 vs 47.3 ng x h/mL, respectively). When the CL/F was corrected for BSA and V/F corrected for weight these differences were no longer evident. In conclusion these exposure differences are not considered clinically relevant, and no dose adjustment of R667 is required based on gender or age.