Publications by authors named "Nicola Taylor"

25 Publications

  • Page 1 of 1

Predicting Infection Risk in Multiple Sclerosis Patients Treated with Ocrelizumab: A Retrospective Cohort Study.

CNS Drugs 2021 Apr 13. Epub 2021 Apr 13.

Department of Neurology, Melbourne MS Centre, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.

Background: Ocrelizumab safety outcomes have been well evaluated in clinical trials and open-label extension (OLE) studies. However, risk factors for infection in patients with multiple sclerosis (MS) receiving ocrelizumab have not been extensively studied in the real-world setting.

Objective: The aim of this study was to examine factors determining risk of self-reported infections and antimicrobial use in patients receiving ocrelizumab for MS.

Methods: A retrospective, observational cohort study was conducted in patients receiving ocrelizumab at the Royal Melbourne Hospital. Infection type and number were reported by patients, and the associations of potential clinical and laboratory risk factors with self-reported infection and antimicrobial use were estimated using univariate and multivariable logistic regression models.

Results: A total of 185 patients were included in the study; a total of 176 infections were reported in 89 patients (46.1%), and antimicrobial use was identified in 47 patients (25.3%). In univariate analyses, a higher serum IgA was associated with reduced odds of infection (OR 0.44, 95% CI 0.25-0.76). In multivariable analyses, older age (OR 0.94, 95% CI 0.88-0.99), higher serum IgA (OR 0.37, 95% CI 0.17-0.80) and higher serum IgG (OR 0.81, 95% CI 0.67-0.99) were associated with reduced odds of infection. Older age (OR 0.85, 95% CI 0.75-0.96) and higher serum IgA (OR 0.23, 95% CI 0.07-0.79) were associated with reduced odds of antimicrobial use, whilst longer MS disease duration (OR 1.22, 95% CI 1.06-1.41) and higher Expanded Disability Status Scale (EDSS) score (OR 1.99, 95% CI 1.02-3.86) were associated with increased odds of antimicrobial use.

Conclusions: Higher serum IgA and IgG and older age were associated with reduced odds of infection. Our findings highlight that infection risk is not uniform in patients with MS receiving ocrelizumab and substantiate the need to monitor immunoglobulin levels pre-treatment and whilst on therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40263-021-00810-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042832PMC
April 2021

Performance Assessment for Rock Climbers: The International Rock Climbing Research Association Sport-Specific Test Battery.

Int J Sports Physiol Perform 2021 Mar 2:1-11. Epub 2021 Mar 2.

Purpose: To examine the validity and reliability of a battery of 10 measures designed to assess the key physiological parameters for successful rock climbing performance.

Methods: In phase 1 of the research, an expert panel, using the Delphi method, established a 10-item test battery based on the key determinants of climbing performance. In phase 2, the tests were assessed for validity and reliability to examine their suitability as sport-specific measures of rock climbing performance. A total of 132 rock climbers, from 7 countries, volunteered to take part in the study. Each climber visited their nearest laboratory on 3 separate occasions in order to enable the required tests and retests to be completed. A minimum of 7 days was allowed between visits.

Results: The 10 tests established for phase 2 were designed as sport-specific measures of flexibility, strength, power, and endurance. Results indicated that, while reliable, the flexibility and strength tests were only partially successful in differentiating across climber abilities. The power and endurance tests, however, performed well with regard to validity and reliability, with the finger hang and powerslap tests being most strongly correlated with performance ability (P < .0005 to P < .002).

Conclusion: The authors' data suggest that climbing may require a threshold level of flexibility and strength for successful performance, beyond which further improvements may not be required. In contrast, the finger hang and powerslap tests were not only reliable measures but also differentiated between climber abilities from lower grade to elite levels.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/ijspp.2020-0672DOI Listing
March 2021

An All-Out Test to Determine Finger Flexor Critical Force in Rock Climbers.

Int J Sports Physiol Perform 2021 Mar 1:1-8. Epub 2021 Mar 1.

Purpose: The fatigue resistance of the finger flexors is known to be a key determinant of climbing performance. This study set out to establish the association between the single all-out assessment of finger flexor critical force (ff-CF) and the impulse above CF (W') on climbing performance (self-reported sport and boulder climbing ability).

Methods: A total of 129 subjects completed an assessment of dominant arm ff-CF, comprised of a series of rhythmic isometric maximum voluntary contractions (CF defined as mean end-test force [in kilograms]; W' impulse above CF [in kilogram second]).

Results: The ff-CF protocol resulted in the same force decay to a plateau seen in previous isometric critical torque and critical force tests. Linear regression analysis, adjusting for sex, revealed that CF percentage of body mass explained 61% of sport and 26% of bouldering performance and W' per kilogram body mass explained 7% sport and 34% bouldering performance. A combined model of CF as a percentage of body mass and W' per kilogram body mass, after adjustment for sex differences, was able to explain 66% of sport climbing and 44% of bouldering performance.

Conclusions: The results illustrate the relevance of the CF threshold in describing the fatigue resistance of the finger flexors of rock climbers. Given ff-CF ability to describe a considerable proportion of variance in sport climbing and bouldering ability, the authors expect it to become a common test used by coaches for understanding exercise tolerance and for determining optimal training prescription.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/ijspp.2020-0637DOI Listing
March 2021

Establishing a clinical psychology team within the orthognathic service: A triad model of orthodontic, maxillofacial and psychological care.

J Orthod 2021 Jan 9:1465312520981588. Epub 2021 Jan 9.

Clinical Health Psychology Services, North East London Foundation Trust (NELFT), London, UK.

The importance of psychological support for orthognathic patients has taken an increasing precedence over recent years and is embedded in orthognathic commissioning guidelines. Furthermore, attention towards mental health-related conditions and their management is of prime importance and continues to be a key area of focus within healthcare settings. With this in mind, this paper aims to outline our experience of establishing a need for and subsequently securing funding to establish a clinical psychology service within an existing orthognathic service in the NHS. The information outlined may be of benefit to orthognathic teams seeking to secure such psychological support within their respective units.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1465312520981588DOI Listing
January 2021

Fast and safe: Optimising multiple sclerosis infusions during COVID-19 pandemic.

Mult Scler Relat Disord 2021 Jan 1;47:102642. Epub 2020 Dec 1.

Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia.

Background: The COVID-19 pandemic challenges multiple sclerosis services to be innovative in delivering infusible therapies. To reduce time in clinical settings, and potential staff or space losses, we implemented rapid infusion protocols for selected patients.

Objective: To analyse the rate of infusion related reactions and patient experience of rapid infusions of natalizumab and ocrelizumab. To document time reduction patients spent in clinical settings during the COVID-19 pandemic.

Methods: Patients with prior exposure to at least three natalizumab or two 300mg ocrelizumab infusions were approved for rapid protocols. A retrospective audit and survey were completed.

Results: We analysed 269 rapid natalizumab infusions and 100 rapid ocrelizumab infusions. Infusion related reactions during the natalizumab or ocrelizumab infusions occurred in two patients (1.52%) and eight patients (8%), respectively. All infusion related reactions were mild to moderate and did not require infusion discontinuation. No infusion reactions occurred during the post-infusion observation. Patient experience was positive.

Conclusion: Frequency or severity of infusion related reactions in rapid infusions were no different compared to published data. In the setting of COVID-19, pandemic rapid infusion protocols could potentially save hospital resources and limit patient exposure to a high-risk clinical setting while still maintaining ongoing treatment of multiple sclerosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.msard.2020.102642DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955770PMC
January 2021

Evaluating the perspective of patients with MS and related conditions on their DMT in relation to the COVID-19 pandemic in one MS centre in Australia.

Mult Scler Relat Disord 2020 Nov 16;46:102516. Epub 2020 Sep 16.

Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of Neuroscience, Monash University, Melbourne, Vic, Australia; MS and Neuroimmunology Department, Alfred Health, Melbourne, Vic, Australia. Electronic address:

Objective: Patients with Multiple Sclerosis (MS) and on disease modifying therapies (DMTs) that can be immunosuppressive or immunomodulatory form a special group where risk of continuation of DMT needs to be taken into account with risk of contracting Covid-19. This concept can pose a degree of anxiety for patients as well as neurologists. We aimed to evaluate patient perspectives regarding the use of Natalizumab and anti-CD20 therapies (Rituximab and Ocrelizumab) in the context of the COVID-19 pandemic.

Methods: cross-sectional study conducted via voluntary survey filled in by patients with MS and related disorders receiving their infusional treatment in one MS centre in Australia, exploring their concerns regarding their therapy, their therapy and COVID-19, precautions undertaken in response to the pandemic, and factors impacting their decision-making.

Results: 170 patients completed the survey. Of patients on Natalizumab, the majority had either no or mild concern regarding their DMT and COVID-19, and of patients on B-cell depleting therapies, again, the majority had no or mild concern, though a slightly higher proportion had a moderate level of concern. Asked to delineate their concerns, an increased risk of contracting COVID-19 was more commonly conveyed than MS-specific factors or poor outcomes pertaining to COVID-19 if contracted, by patients in both groups. Conversely, being invited to specifically consider the possibility of contracting COVID-19 or experience a relapse of MS, almost half of the cohort rated both of equal of concern. More than half of the cohort were self-isolating more stringently than general government advice and government-related resources followed by information provided by patient's neurologist where the commonest means of information to guide decision making.

Conclusions: Whilst a large proportion of patients had some concern regarding the impact of their DMT on COVID-19, whether on their risk of contracting COVID-19 or a theoretical risk for more severe disease, the overall level of concern in most cases was at most mild. Patients on B-cell depleting therapies were more inclined to express a higher level of concern. A similar concern was ascribed to a risk of a relapse or worsening MS symptoms compared to the risk of contracting COVID-19. Such attitudes may underscore a willingness of patients to continue their DMT where benefits outweigh risks during future phases of the COVID-19 pandemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.msard.2020.102516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493747PMC
November 2020

Memory During the Presumed Vegetative State: Implications for Patient Quality of Life.

Camb Q Healthc Ethics 2020 10;29(4):501-510

A growing number of studies show that a significant proportion of patients, who meet the clinical criteria for the diagnosis of the vegetative state (VS), demonstrate evidence of covert awareness through successful performance of neuroimaging tasks. Despite these important advances, the day-to-day life experiences of any such patient remain unknown. This presents a major challenge for optimizing the patient's standard of care and quality of life (QoL). We describe a patient who, following emergence from a state of complete behavioral unresponsiveness and a clinical diagnosis of VS, reported rich memories of his experience during this time. This case demonstrates the potential for a sophisticated mental life enabled by preserved memory in a proportion of patients who, similarly, are thought to be unconscious. Therefore, it presents an important opportunity to examine the implications for patient QoL and standard of care, both during the period of presumed unconsciousness and after recovery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0963180120000274DOI Listing
October 2020

Anthropometry and performance characteristics of recreational advanced to elite female rock climbers.

J Sports Sci 2021 Jan 18;39(1):48-56. Epub 2020 Aug 18.

MOVE-IT Research group and Department of Physical Education, Faculty of Education Sciences University of Cádiz , Cádiz, Spain.

Despite climbing's popularity and an increasing number of female participants, there are limited anthropometric and performance data for this population. This study compares the characteristics of 55 experienced female climbers, divided into three categories (lower [ADV-L] and higher advanced [ADV-H] and elite [ELT]) based on self-reported ability. Data on climbing experience, body dimensions, body composition, flexibility, lower and upper-body power and finger strength were assessed. ELT climbers differed significantly from the ADV groups in age (Mean Difference [MD] = 8.8-9.8 yrs; despite smaller differences in years climbing MD = 1.6-2.4 yrs), greater climbing and hours training per week (MD = 3.0-3.7 h & MD = 0.9-1.6 h, respectively), and greater upper-body power (MD = 12.9-16.6 cm) and finger strength (MD = 51.6-65.4 N). Linear regression analysis showed finger strength and upper body power to be associated with ability, particularly when adjusting for descriptive and anthropometric variables (finger strength R = 53% and 45%; upper-body power R = 60% and 39% for boulder and sport, respectively). The findings support the importance of finger strength and upper-body power; changes in female anthropometric data over the last decade provide insight into the changing nature of the sport.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/02640414.2020.1804784DOI Listing
January 2021

The Visual Search Strategies Underpinning Effective Observational Analysis in the Coaching of Climbing Movement.

Front Psychol 2020 28;11:1025. Epub 2020 May 28.

Human Sciences Research Centre, College of Life and Natural Sciences, University of Derby, Derby, United Kingdom.

Despite the importance of effective observational analysis in coaching the technical aspects of climbing performance, limited research informs this aspect of climbing coach education. Thus, the purpose of the present research was to explore the feasibility and the utility of a novel methodology, combining eye tracking technology and cued retrospective think-aloud (RTA), to capture the cognitive-perceptual mechanisms that underpin the visual search behaviors of climbing coaches. An analysis of gaze data revealed that expert climbing coaches demonstrate fewer fixations of greater duration and fixate on distinctly different areas of the visual display than their novice counterparts. Cued RTA further demonstrated differences in the cognitive-perceptual mechanisms underpinning these visual search strategies, with expert coaches being more cognizant of their visual search strategy. To expand, the gaze behavior of expert climbing coaches was underpinned by hierarchical and complex knowledge structures relating to the principles of climbing movement. This enabled the expert coaches to actively focus on the most relevant aspects of a climber's performance for analysis. The findings demonstrate the utility of combining eye tracking and cued RTA interviewing as a new, efficient methodology of capturing the cognitive-perceptual processes of climbing coaches to inform coaching education/strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyg.2020.01025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326104PMC
May 2020

A Novel Tool for the Assessment of Sport Climbers' Movement Performance.

Int J Sports Physiol Perform 2020 Jul 27;15(6):795-800. Epub 2020 Feb 27.

Purpose: To assess the validity and reliability of a novel movement-performance assessment tool for climbing/sport climbing.

Methods: First, salient climbing movement-performance factors were identified through an iterative consultation process with 10 expert climbing coaches; the resulting Climber's Movement Performance Assessment Tool (CM-PAT) contained 14 items in 5 categories. Second, 61 intermediate to advanced climbers ascended a single route, which was video recorded. Subsequently, 4 experienced (>10 y coaching) coaches used the CM-PAT to observe and score the climbers' performance. Interrater reliability and comparisons with existing measures of climbing performance (6-mo self-reported ability, success and failure, climbing pace [m·min-1], and geometric entropy) were made.

Results: Intraclass correlation coefficient (2,k) for the 4 raters demonstrated excellent reliability (>.81) between observers and good to excellent test-retest reliability (.71-.91). Pearson correlations between self-reported ability and CM-PAT scores explained 61% of the variance in self-reported climbing performance compared with 16% for geometric entropy and 52% for climbing pace. Considering differences in successful and unsuccessful climbers, the CM-PAT (P < .0005; d = 2.14), geometric entropy (P = .014; d = 0.67), and pace (P < .0005; d = 1.88) were able to differentiate between groups.

Conclusions: The CM-PAT is the first sport climbing performance observational instrument to be developed through a thorough iterative process with expert coaches. Excellent interrater and test-retest reliability and excellent agreement with self-reported ability and with existing quantitative measures of performance support its recommendation for use in coaching and research contexts. Notably, a key advantage over existing measures is the identification of coachable elements of performance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/ijspp.2019-0311DOI Listing
July 2020

Genetic and Inflammatory Biomarkers Classify Small Intestine Inflammation in Asymptomatic First-degree Relatives of Patients With Crohn's Disease.

Clin Gastroenterol Hepatol 2020 04 14;18(4):908-916.e13. Epub 2019 Jun 14.

Department of Gastroenterology, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, United Kingdom.

Background & Aims: Relatives of individuals with Crohn's disease (CD) carry CD-associated genetic variants and are often exposed to environmental factors that increase their risk for this disease. We aimed to estimate the utility of genotype, smoking status, family history, and biomarkers can calculate risk in asymptomatic first-degree relatives of patients with CD.

Methods: We recruited 480 healthy first-degree relatives (full siblings, offspring or parents) of patients with CD through the Guy's and St Thomas' NHS Foundation Trust and from members of Crohn's and Colitis, United Kingdom. DNA samples were genotyped using the Immunochip. We calculated a risk score for 454 participants, based on 72 genetic variants associated with CD, family history, and smoking history. Participants were assigned to highest and lowest risk score quartiles. We assessed pre-symptomatic inflammation by capsule endoscopy and measured 22 markers of inflammation in stool and serum samples (reference standard). Two machine-learning classifiers (elastic net and random forest) were used to assess the ability of the risk factors and biomarkers to identify participants with small intestinal inflammation in the same dataset.

Results: The machine-learning classifiers identified participants with pre-symptomatic intestinal inflammation: elastic net (area under the curve, 0.80; 95% CI, 0.62-0.98) and random forest (area under the curve, 0.87; 95% CI, 0.75-1.00). The elastic net method identified 3 variables that can be used to calculate odds for intestinal inflammation: combined family history of CD (odds ratio, 1.31), genetic risk score (odds ratio, 1.14), and fecal calprotectin (odds ratio, 1.04). These same 3 variables were among the 5 factors associated with intestinal inflammation in the random forest model.

Conclusion: Using machine learning classifiers, we found that genetic variants associated with CD, family history, and fecal calprotectin together identify individuals with pre-symptomatic intestinal inflammation who are therefore at risk for CD. A tool for detecting people at risk for CD before they develop symptoms would help identify the individuals most likely to benefit from early intervention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cgh.2019.05.061DOI Listing
April 2020

The Determination of Finger-Flexor Critical Force in Rock Climbers.

Int J Sports Physiol Perform 2019 07 1;14(7):972-979. Epub 2019 Jul 1.

To determine if the mathematical model used for the estimation of critical force (CF) and the energy store component ' are applicable to intermittent isometric muscle actions of the finger flexors of rock climbers, using a multisession test. As a secondary aim, the agreement of estimates of CF and ' from a single-session test was also determined. The CF was defined as the slope coefficient, and ' was the intercept of the linear relationship between total "isometric work" () and time to exhaustion (). Subjects performed 3 (separated by either 20 min or >24 h) tests to failure using intermittent isometric finger-flexor contractions at 45%, 60%, and 80% of their maximum voluntary contraction. Force plotted against displayed a hyperbolic relationship; correlation coefficients of the parameter estimates from the work-time CF model were consistently very high ( > .94). Climbers' mean CF was 425.7 (82.8) N (41.0% [6.2%] maximum voluntary contraction) and ' was 30,882 (11,820) N·s. Good agreement was found between the single-session and multisession protocol for CF (intraclass correlation coefficient [ICC] = .900; 95% confidence interval, .616-.979), but not for ' (ICC = .768; 95% confidence interval, .190-.949). The results demonstrated the sensitivity of a simple test for the determination of CF and ', using equipment readily available in most climbing gyms. Although further work is still necessary, the test of CF described is of value for understanding exercise tolerance and to determine optimal training prescription to monitor improvements in the performance of the finger flexors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/ijspp.2018-0809DOI Listing
July 2019

The impact of an inflammatory bowel disease nurse-led biologics service.

Frontline Gastroenterol 2016 Oct 7;7(4):283-288. Epub 2016 Jul 7.

Department of Gastroenterology, Southampton General Hospital, Southampton, UK.

Introduction: Southampton General Hospital provides inflammatory bowel disease (IBD) services for a population of 650 000. Biological agents have impacted hugely on IBD but are costly drugs requiring careful supervision. These challenges led us to develop a specialist nurse-led biologics service to improve patient care.

Method: A 2010 case note audit highlighted areas for improvement in monitoring biologics and follow-up. A business case was developed to establish an IBD nurse to ensure identification and appropriate screening, education and review of biologics patients. A gain share was agreed with the local Care Commissioning Group (CCG) and £60 000 invested. Outcomes were reaudited in 2014.

Results: Biologic use has grown rapidly from 90 patients in 2011 to 330 in 2014. All records are now kept in a centralised database. Infection screening improved from 79% to 100%. In 2014, 96% of patients had follow-up ≤4 months post-induction to assess response, but two patients were seen at 7 months. 80% were followed up again at 9-12 months (100% at 9-14 months), all with treatment decisions. The initial investment was recouped via commissioners funding 368 additional outpatient appointments and 35 colonoscopies. Savings represented 15% total yearly biologic costs.

Conclusions: The introduction of the IBD biologics nurse-led service resulted in significant gains in care quality and costs. The need for improved follow-up of patients on biologics reflects increased pressures on clinic resources across the country. With continued biologics expansion, the introduction of a biologics nurse has provided invaluable support to patients and the IBD team at Southampton General Hospital.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/flgastro-2016-100696DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369502PMC
October 2016

Student life - A collaborative approach to pre-registration education.

Nurs Stand 2017 Jun;31(42):35

Norfolk and Norwich University Hospital NHS Foundation Trust.

Collaborative learning is essential to the education of pre-registration nurses. At Norfolk and Norwich University Hospitals NHS Foundation Trust we have adopted a coaching approach to education using the Collaborative Learning in Practice (CLiP) model.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7748/ns.31.42.35.s40DOI Listing
June 2017

Generally representative is generally representative: comment on Shuttleworth-Edwards.

Authors:
Nicola Taylor

Clin Neuropsychol 2016 Oct 29;30(7):1017-22. Epub 2016 Jul 29.

a JvR Psychometrics , Johannesburg , South Africa.

Objective: The aim of this paper is to provide comment on Shuttleworth-Edwards' criticism of the general population norms created for the South African adaptation of the WAIS-IV. In her criticism, she states that the norms are not applicable for any groups in South Africa, based on the fact that the norms were not stratified according to quality of education.

Method: A discussion of some of the key issues that impact on the creation of general population norms in the South African context is provided. Demographic characteristics such as education level, quality of education, urban and rural demarcations, and home language are all considered.

Results: While the utility of within-group norms is not denied, the adoption of these without reference to the general population is not advised. To recommend that practitioners simply dispense with the general population norm without evidence that it creates misclassification or does not function effectively for the intended population lacks scientific merit at the current time.

Conclusions: The need for clinical studies and further predictive validity research using the South African adaptation of the WAIS-IV is crucial to demonstrate the continued utility of the test in the South African context. Additional reference groups will improve the amount of comparative information available for clinicians to be able to make better informed decisions for diagnosis, but the general population norms will be an important starting point in this process.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13854046.2016.1213884DOI Listing
October 2016

Incremental cholecalciferol supplementation up to 15 μg/d throughout winter at 51-55° N has no effect on biomarkers of cardiovascular risk in healthy young and older adults.

J Nutr 2012 Aug 27;142(8):1519-25. Epub 2012 Jun 27.

Vitamin D Research Group, School of Food and Nutritional Sciences, University College, Cork, Ireland.

Two separate, identical, double-blind, randomized, placebo-controlled intervention studies were carried out in the south and north of Ireland (51-55°N). Men and women aged 20-40 y (n = 202) and ≥64 y (n = 192) received cholecalciferol at doses of 0 (P), 5 (D3-5), 10 (D3-10), or 15 (D3-15) μg/d (0-600 IU) during wintertime. Serum 25-hydroxyvitamin D [s25(OH)D], intact parathyroid hormone, systolic and diastolic blood pressure, fasting lipids, glucose and insulin, HOMA-IR, high-sensitivity CRP, matrix metalloproteinase-9, and its inhibitor (tissue inhibitor metalloproteinase-1) were measured at baseline (October) and 22 wk later at endpoint (March). Vitamin D receptor Fok I and Taq I genotypes were analyzed and dietary intakes of vitamin D and calcium were assessed. In young adults, s25(OH)D decreased from baseline to endpoint (P < 0.001), except in the D3-15 group, who maintained the baseline concentration of ~70 nmol/L. Older adults had lower s25(OH)D at baseline (median, 54.2 nmol/L) and concentrations increased in the D3-10 and D3-15 groups (P < 0.001). There were no significant effects of supplementation on cardiovascular disease (CVD) risk biomarkers in either age group. Fasting glucose and total and HDL cholesterol were lower (P < 0.05) in older adults with the Fok 1 ff genotype than in those with FF or Ff. Putative effects of vitamin D on cardio-metabolic health will only be evident at higher intakes than the current RDA and possibly in individuals at particular risk of low s25(OH)D and/or CVD risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3945/jn.111.154005DOI Listing
August 2012

Can teaching veterinary and animal-science students about animal welfare affect their attitude toward animals and human-related empathy?

J Vet Med Educ 2011 ;38(1):74-83

School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, Australia.

Attitudes toward animals are important in influencing how animals are treated. Few studies have investigated attitudes toward animals in veterinary or animal-science students, and no studies have compared attitudes to animals before and after a course teaching animal welfare and ethics. In this study, students enrolled in veterinary (first-year) or animal-science (first- and third-year) programs completed a questionnaire on attitudes toward different categories of animals before and after the course. Higher attitude scores suggest a person more concerned about how an animal is treated. Normally distributed data were compared using parametric statistics, and non-normally distributed data were compared using non-parametric tests, with significance p < .05. Attitudes toward pets (45.5-47.6) were higher than those toward pests (34.2-38.4) or profit animals (30.3-32.1). Attitude scores increased from before to after the course in the veterinary cohort on the Pest (36.9 vs. 38.4, respectively, n = 27, p < .05) and Profit (30.3 vs. 32.1, respectively, n = 28, p < .05) subscales, but not in the animal-science cohorts. Attitude scores in all categories were higher for women than for men. Currently having an animal was associated with higher pet scores (46.8 vs. 43.8, ns = 120 and 13, respectively, p < .05), and having an animal as a child was associated with higher profit scores (31.0 vs. 26.6, ns = 129 and 8, respectively, p < .05). Students electing to work with livestock had lower scores on the Pest and Profit subscales, and students wanting to work with wildlife had significantly higher scores on the Pest and Profit subscales. This study demonstrates attitudinal changes after an animal-welfare course, with significant increases in veterinary but not animal-science students.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3138/jvme.38.1.74DOI Listing
November 2011

Cholecalciferol supplementation throughout winter does not affect markers of bone turnover in healthy young and elderly adults.

J Nutr 2010 Mar 20;140(3):454-60. Epub 2010 Jan 20.

Department of Food and Nutritional Sciences, University College, Cork, Ireland.

Although there have been several studies of the effect of vitamin D status on bone turnover in the elderly, the findings are unclear, and, furthermore, to date very few have investigated this in young adults. The objective of these randomized, placebo-controlled, double-blind, 2-center intervention studies was to investigate the effect of cholecalciferol supplementation (0, 5, 10, and 15 microg cholecalciferol/d) throughout winter time on indices of vitamin D status and bone turnover in young (aged 20-40 y; n = 215) and elderly (aged > or = 64 y; n = 204) adults, with relatively high mean calcium intakes of 976 and 874 mg/d, respectively. Fasting serum concentrations of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), osteocalcin, bone-specific alkaline phosphatase, and carboxyterminal collagen crosslinks were measured by enzyme immunoassays at baseline and endpoint. Fok I and Taq I vitamin D receptor (VDR) genotypes were determined by real-time PCR. Endpoint serum 25(OH)D increased (P < 0.0001) in a dose-related manner with increasing supplemental cholecalciferol (up to 15 microg/d) in 20-40-y olds and up to 10 microg/d in > or = 64-y olds. Endpoint serum PTH was lower (P < 0.05) in the 3 cholecalciferol-supplemented groups compared with that in the placebo group in > or = 64-y olds, but cholecalciferol supplementation did not affect other markers in either cohort and there was no significant interaction with VDR genotype. In conclusion, cholecalciferol supplementation alone throughout winter did not affect bone turnover markers in apparently healthy young and elderly adults, even when stratified by VDR genotype.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3945/jn.109.113480DOI Listing
March 2010

Estimation of the dietary requirement for vitamin D in free-living adults >=64 y of age.

Am J Clin Nutr 2009 May 18;89(5):1366-74. Epub 2009 Mar 18.

Department of Food and Nutritional Sciences, University College, Cork, Ireland.

Background: Older adults may be more prone to developing vitamin D deficiency than younger adults. Dietary requirements for vitamin D in older adults are based on limited evidence.

Objective: The objective was to establish the dietary intake of vitamin D required to maintain serum 25-hydroxyvitamin D [25(OH)D] concentrations above various cutoffs between 25 and 80 nmol/L during wintertime, which accounted for the effect of summer sunshine exposure and diet.

Design: A randomized, placebo-controlled, double-blind, 22-wk intervention was conducted in men and women aged >/=64 y (n = 225) at supplemental levels of 0, 5, 10, and 15 microg vitamin D(3)/d from October 2007 to March 2008.

Results: Clear dose-related increments (P < 0.0001) in serum 25(OH)D were observed with increasing supplemental vitamin D(3) intakes. The slope of the relation between total vitamin D intake and serum 25(OH)D was 1.97 nmol . L(-1) . microg intake(-1). The vitamin D intake that maintained serum 25(OH)D concentrations >25 nmol/L in 97.5% of the sample was 8.6 microg/d. Intakes were 7.9 and 11.4 microg/d in those who reported a minimum of 15 min daily summer sunshine exposure or less, respectively. The intakes required to maintain serum 25(OH)D concentrations of >37.5, >50, and >80 nmol/L in 97.5% of the sample were 17.2, 24.7, and 38.7 microg/d, respectively.

Conclusion: To ensure that the vitamin D requirement is met by the vast majority (>97.5%) of adults aged >/=64 y during winter, between 7.9 and 42.8 microg vitamin D/d is required, depending on summer sun exposure and the threshold of adequacy of 25(OH)D. This trial was registered at http://www.controlled-trials.com/ISRCTN20236112 as ISRCTN registration no. ISRCTN20236112.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3945/ajcn.2008.27334DOI Listing
May 2009

Estimation of the dietary requirement for vitamin D in healthy adults.

Am J Clin Nutr 2008 Dec;88(6):1535-42

Department of Food and Nutritional Sciences, University College, Cork, Ireland.

Background: Knowledge gaps have contributed to considerable variation among international dietary recommendations for vitamin D.

Objective: We aimed to establish the distribution of dietary vitamin D required to maintain serum 25-hydroxyvitamin D [25(OH)D] concentrations above several proposed cutoffs (ie, 25, 37.5, 50, and 80 nmol/L) during wintertime after adjustment for the effect of summer sunshine exposure and diet.

Design: A randomized, placebo-controlled, double-blind 22-wk intervention study was conducted in men and women aged 20-40 y (n = 238) by using different supplemental doses (0, 5, 10, and 15 microg/d) of vitamin D(3) throughout the winter. Serum 25(OH)D concentrations were measured by using enzyme-linked immunoassay at baseline (October 2006) and endpoint (March 2007).

Results: There were clear dose-related increments (P < 0.0001) in serum 25(OH)D with increasing supplemental vitamin D(3). The slope of the relation between vitamin D intake and serum 25(OH)D was 1.96 nmol x L(-1) x microg(-1) intake. The vitamin D intake that maintained serum 25(OH)D concentrations of >25 nmol/L in 97.5% of the sample was 8.7 microg/d. This intake ranged from 7.2 microg/d in those who enjoyed sunshine exposure, 8.8 microg/d in those who sometimes had sun exposure, and 12.3 microg/d in those who avoided sunshine. Vitamin D intakes required to maintain serum 25(OH)D concentrations of >37.5, >50, and >80 nmol/L in 97.5% of the sample were 19.9, 28.0, and 41.1 microg/d, respectively.

Conclusion: The range of vitamin D intakes required to ensure maintenance of wintertime vitamin D status [as defined by incremental cutoffs of serum 25(OH)D] in the vast majority (>97.5%) of 20-40-y-old adults, considering a variety of sun exposure preferences, is between 7.2 and 41.1 microg/d.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3945/ajcn.2008.26594DOI Listing
December 2008

A pilot investigation of a psychosocial activity course for people with spinal cord injuries.

Psychol Health Med 2006 Feb;11(1):91-9

National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.

This study investigated the general benefits and impact that sports activity courses organized by Back-Up, a charitable trust, have on quality of life, mood, self-efficacy and perceived manageability. Participants were 35 community-based individuals with spinal cord injuries (SCI). Questionnaires were completed at the start and end of the course. Fourteen participants also completed the follow-up questionnaire. Questionnaires included demographic questions, the Life Satisfaction Questionnaire, the Hospital Anxiety and Depression Scale, a measure of Perceived Manageability, the Generalised Self-Efficacy Scale and four questions about what participants had gained. Results found that participants' satisfaction with leisure, generalized self-efficacy and motivation to engage in activities was significantly increased between the start and end of the courses and anxiety significantly reduced. Such results were in line with participants' responses relating to overall gains from the course. At both the start and end of the course, higher Perceived Manageability scores correlated with greater self-efficacy and higher Perceived Manageability scores and self-efficacy were correlated with lower depression and anxiety. The study provides evidence of the benefits of sports participation and teamwork for people with SCI, confirming the results of previous research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13548500500330494DOI Listing
February 2006

Community demographics and the propensity to report animal cruelty.

J Appl Anim Welf Sci 2006 ;9(3):201-10

School of Psychology and Sociology, Central Queensland University, Rockhampton, QLD, Australia.

The last decade has seen an increased awareness concerning links between violence to nonhuman animals and violence to humans. This has resulted in a number of cross-reporting initiatives between family service providers and animal welfare organizations. The success of these initiatives rests on individuals being willing to report such violence. Thus, there is a need to determine which variables influence an individual's willingness to report deliberate animal cruelty and abuse. The aim of this study was to examine demographic and attitudinal variables to ascertain their impact on propensity to report deliberate animal harm. A telephone questionnaire resulted in 1,208 valid responses from members of the general community. Results showed a number of variables that affected the propensity to report: gender, occupation, and acknowledgment of the link between family violence and deliberate animal harm. This article discusses these variables and their implications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1207/s15327604jaws0903_2DOI Listing
December 2006

Measuring quality of life in women with endometriosis: tests of data quality, score reliability, response rate and scaling assumptions of the Endometriosis Health Profile Questionnaire.

Hum Reprod 2006 Oct 4;21(10):2686-93. Epub 2006 Jul 4.

School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, and Nuffield Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford, UK.

Background: To test the data quality, scaling assumptions and scoring algorithms underlying the Endometriosis Health Profile-30 (EHP-30) questionnaire: a questionnaire developed to measure the health-related quality of life (HRQoL) of women with endometriosis.

Methods: A cross-sectional postal survey to 727 women with surgically confirmed endometriosis recruited from an existing genetic linkage study (OXEGENE), The National Endometriosis Society (NES), UK and the outpatient gynaecology clinics of the Women's Centre, John Radcliffe Hospital, Oxford. Tests of data quality included secondary factor analysis, internal reliability consistency, descriptive statistics of the data, missing data levels, floor and ceiling effects and corrected item to total correlation scores.

Results: Six hundred and ten women (83.9%) returned the questionnaire. Secondary factor analysis verified the domain structure of the EHP-30. All 11 dimensions were internally reliable with Cronbach's alpha scores ranging from 0.80 to 0.96. Missing response rates ranged from 0.2 to 1.3%, and all items were found to be most highly correlated with their own (corrected) scale.

Conclusions: Results confirmed the factor structure, scoring and scaling assumptions of the questionnaire. The high rate of data completeness indicated that the EHP-30 was acceptable and understandable to the respondents, thereby verifying its suitability for measuring the HRQoL of women with endometriosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/humrep/del231DOI Listing
October 2006

The association of sports and physical recreation with life satisfaction in a community sample of people with spinal cord injuries.

NeuroRehabilitation 2005 ;20(4):253-65

Institute of Rehabilitation, University School of Physical Education, Poznań, Poland.

The purpose of this study is to assess satisfaction with life domains in people with spinal cord injuries (SCI) and investigate whether participation in sports and physical recreation is associated with life satisfaction in SCI. 1,748 randomly selected participants with SCI who fulfilled the criteria: SCI at level C5 or below, wheelchair dependent; aged 18-50 at the time of injury; at least 1 year post-injury, were approached to take part in this study. Completed replies were received from 985 individuals with SCI (198 women, 798 men). The measures used included the Sports Participation Questionnaire, the Life Satisfaction Questionnaire and the Hospital Anxiety and Depression Scale. The numbers of hours participating in sports decreased significantly after injury. There was a greater decrease in numbers participating in team sports in comparison to the decrease seen in numbers participating in individual sports. The highest level of satisfaction existed within social domains such as: family life and contacts with friends. The lowest level of satisfaction was found in regard to the participant's sexual life and vocational situation. Higher satisfaction with life in general was demonstrated in respondents with SCI involved in sports or physical recreation compared to those not participating in physical activities.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2006