Rugby as a rehabilitation program in a United Kingdom Male Young Offenders' Institution: key findings and implications from mixed methods research.

There is a growing body of research on the effectiveness of rehabilitation programs in a Young Offenders' Institution (YOI). The aim of the present study is to investigate the effectiveness of rugby training as a rehabilitation intervention in a YOI in the United Kingdom. Young adult males (n=46) currently serving sentences at the YOI were split into two groups, intervention (n=25; mean age, 19.64±0.81 years) and no intervention (n=21; mean age, 19.76±0.89). Participants completed the Criminal Attitudes and Associates (MCAA) instrument at three different time cycles and then pre/post for intervention group. Additionally, qualitative interviews (one to one and focus groups) were carried out with the intervention and no intervention groups during the same cycles of the study. The results of questionnaire analysis showed no significant difference in MCAA measures taken before and after rugby intervention. Interestingly, the intervention group showed more procriminal attitudes on their responses compared to the no intervention group. Finally, analysis of the 3 cycles of data collected showed that the time of the year the questionnaire was completed has a significant impact on the responses given. In contrast, the qualitative interviews showed a very positive change of attitude towards rehabilitation from the intervention group after rugby training. The implications of the results in relation to studies aimed at evaluation of the intervention programs in YOI are discussed.

Perspective: Dietary Biomarkers of Intake and Exposure-Exploration with Omics Approaches.

While conventional nutrition research has yielded biomarkers such as doubly labeled water for energy metabolism and 24-h urinary nitrogen for protein intake, a critical need exists for additional, equally robust biomarkers that allow for objective assessment of specific food intake and dietary exposure. Recent advances in high-throughput MS combined with improved metabolomics techniques and bioinformatic tools provide new opportunities for dietary biomarker development. In September 2018, the NIH organized a 2-d workshop to engage nutrition and omics researchers and explore the potential of multiomics approaches in nutritional biomarker research. The current Perspective summarizes key gaps and challenges identified, as well as the recommendations from the workshop that could serve as a guide for scientists interested in dietary biomarkers research. Topics addressed included study designs for biomarker development, analytical and bioinformatic considerations, and integration of dietary biomarkers with other omics techniques. Several clear needs were identified, including larger controlled feeding studies, testing a variety of foods and dietary patterns across diverse populations, improved reporting standards to support study replication, more chemical standards covering a broader range of food constituents and human metabolites, standardized approaches for biomarker validation, comprehensive and accessible food composition databases, a common ontology for dietary biomarker literature, and methodologic work on statistical procedures for intake biomarker discovery. Multidisciplinary research teams with appropriate expertise are critical to moving forward the field of dietary biomarkers and producing robust, reproducible biomarkers that can be used in public health and clinical research.

Defining Extreme Sport: Conceptions and Misconceptions.

One feature of how sport is defined is the distinction between extreme and non-extreme sport. BASE jumping is an example of an "extreme sport" because it involves a high degree of risk, whilst swimming is classified as "non-extreme" because the risks involved are minimal. This broad definition falls short of identifying the extent of risk and ignores the psychological, social-demographic and life style variables associated with engagement in each sport.

Personality differences amongst drag racers and archers: implications for sport injury rehabilitation.

Personality trait of an athlete is a significant factor in sports injury rehabilitation. The aim of the present study is to investigate whether there are differences in personality traits between male and female, professional and amateur athletes from sports representing two ends of extreme to traditional namely; drag racing and archery. Overall 189 male and female, professional and amateur drag racers (n=144) and archers (n=45) took part in this study. Participants completed the personality traits of extroversion and neuroticism as measured by Eysenck's classic Personality Inventory dimensions and thrill and adventure seeking (TAS), experience seeking (ES), disinhibition (DIS), boredom susceptibility (BS), and sensation seeking (SS) as measured by Zuckerman's Sensation Seeking Scale. The results showed that professionals scored significantly lower on neuroticism compared to amateurs. Drag racers scored significantly higher on TAS, DIS, and SS compared to archers and there were gender differences amongst archers on TAS and SS with males scoring higher than females. Such differences in personality factors and the readiness to take risks, lack of caution, and adventurous spirit can influence the risk of injury in athletes and indeed may influence the outcome of rehabilitation. Practitioners would need to recognise difference in personality traits associated with the type of sport and the choice of interventions strategies.

Diet, Microbiome, and Epigenetics in the Era of Precision Medicine.

Precision medicine is a revolutionary approach to disease prevention and treatment that takes into account individual differences in lifestyle, environment, and biology. The US National Institutes of Health has recently launched The All of Us Research Program (2016) to extend precision medicine to all diseases by building a national research cohort of one million or more US participants. This review is limited to how the human microbiome factors into precision medicine from the applied aspect of preventing and managing cancer. The Precision Medicine Initiative was established in an effort to address particular characteristics of each person with the aim to increase the effectiveness of medical interventions in terms of prevention and treatment of multiple diseases including cancer. Many factors contribute to the response to an intervention. The microbiome and microbially produced metabolites are capable of epigenetic modulation of gene activity, and can influence the response through these mechanisms. The fact that diet has an impact on microbiome implies that it will also affect the epigenetic mechanisms involving microbiota. In this chapter, we review some major epigenetic mechanisms, notably DNA methylation, chromatin remodeling and histone modification, and noncoding RNA, implicated in cancer prevention and treatment. Several examples of how microbially produced metabolites from food influence cancer risk and treatment response through epigenetic mechanisms will be discussed. Some challenges include the limited understanding of how diet shapes the microbiome and how to best evaluate those changes since both, diet and the microbiota, exhibit daily and seasonal variations. Ongoing research seeks to understand the relationship between the human microbiome and multiple diseases including cancer.

A Cross-Continental Study on Children's Drawings of Football Players: Implications for Understanding Key Issues and Controversies in Human Figure Drawings.

Professionals examine various aspects of girls' and boys' drawings as a way of understanding their intelligence, personality and emotional state. However, the extent to which such measures could be universally generalised or attributed to a specific cultural norm is still a debatable issue. In the present study five key features of children's drawings namely: the size (height) of the drawings, profile or full face, figure in action or static, shaded or non-shaded and the nature of additional details were examined from a cross-cultural perspective, and by providing a topic (football) for which children's drawing of a human figure could provide opportunities for the latter indices to manifest and flourish. Children from three countries; England, Iran and Brazil, representing three continents took part in this study. The participants were asked to draw a football player from their own country and from the other participating countries. The results showed that Brazilian children differ from Iranian and English children by drawing significantly smaller figures and putting more football action in the drawings. Shading of the figure drawn was more prevalent amongst English children. Such findings have implications for the interpretation of key aspects of children's drawings in educational, clinical and therapeutic settings and from a universal vs. culturally-specific viewpoint.

Effects of physical activity on debilitating behaviours in 13- to 20-year-old males with severe autism spectrum disorder.

The presented study investigated the extent to which engaging in a therapeutic sporting programme in males with severe autism spectrum disorder (ASD) improves the debilitating behaviours commonly associated with ASD. Furthermore, the views of parents of the autistic participants were assessed concerning the effectiveness of the programme. Participants were eight 13- to 20-year-old males born in the United Kingdom from a school and sports college for pupils with severe learning difficulties. The selection was using volunteer sampling from the "Monday Club" initiative, run by Saracens Sports Foundation in partnership with a local school and specialist sports college. The Gilliam Autism Rating Scale, 3rd edition was administered to identify and measure the severity of ASD behaviours at four time periods namely: at programme entry as the baseline (Time 1, T1), a second time after 8 weeks (Time 2, T2), a third time after 16 weeks (Time 3, T3), and a fourth time post programme (Time 4, T4). The results showed that for the more severe cases of ASD (Autism Index >101) there was no positive change in subscale performance from T1 to T2. For milder cases (Autism Index, 71-100) there were subtle non-significant improvements on the subscale scores from T1 to T2. Of the 6 subscales at T2, emotional responses, cognitive style, and maladaptive speech approached significance at the P=0.05 level. At T3 and T4, there was also no statistically significant improvement in ASD behaviours compared to the baseline for either condition. Finally parents' were "very satisfied" with their child's participation in the physical activity programme.

Omics for Understanding the Gut-Liver-Microbiome Axis and Precision Medicine.

Human metabolic disease opens a new view to understanding the contribution of the intestinal microbiome to drug metabolism and drug-induced toxicity in gut-liver function. The gut microbiome, a key determinant of intestinal inflammation, also plays a direct role in chronic inflammation and liver disease. Gut bacterial communities directly metabolize certain drugs, reducing their bioavailability and influencing individual variation in drug response. In addition, some microbiome-produced compounds may affect drug pharmacokinetics and pharmacodynamics via altered expression of metabolizing enzymes and drug transporters or genes coding for drug target proteins, drug response phenotypes, and disease states. Molecular-based high-throughput technologies are providing novel insight about host-gut microbiome interactions, homeostasis, and xenobiotic effects associated with wide variation in efficacy or toxicity in humans. It is envisioned that future approaches to treating and preventing liver disease will benefit from in-depth studies of the liver-microbiome axis. Thus, the microbiome shares a fundamental role in human physiology with various organ systems, and its importance must be considered in the rapid evolution of precision medicine. A new emerging perspective of understanding the effect of the gut microbiome on human response to drugs would be indispensable for developing efficacious, safe, and cost-effective precision therapies.

Progress and challenges in developing metabolic footprints from diet in human gut microbial cometabolism.

Homo sapiens harbor trillions of microbes, whose microbial metagenome (collective genome of a microbial community) using omic validation interrogation tools is estimated to be at least 100-fold that of human cells, which comprise 23,000 genes. This article highlights some of the current progress and open questions in nutrition-related areas of microbiome research. It also underscores the metabolic capabilities of microbial fermentation on nutritional substrates that require further mechanistic understanding and systems biology approaches of studying functional interactions between diet composition, gut microbiota, and host metabolism. Questions surrounding bacterial fermentation and degradation of dietary constituents (particularly by Firmicutes and Bacteroidetes) and deciphering how microbial encoding of enzymes and derived metabolites affect recovery of dietary energy by the host are more complex than previously thought. Moreover, it is essential to understand to what extent the intestinal microbiota is subject to dietary control and to integrate these data with functional metabolic signatures and biomarkers. Many lines of research have demonstrated the significant role of the gut microbiota in human physiology and disease. Probiotic and prebiotic products are proliferating in the market in response to consumer demand, and the science and technology around these products are progressing rapidly. With high-throughput molecular technologies driving the science, studying the bidirectional interactions of host-microbial cometabolism, epithelial cell maturation, shaping of innate immune development, normal vs. dysfunctional nutrient absorption and processing, and the complex signaling pathways involved is now possible. Substantiating the safety and mechanisms of action of probiotic/prebiotic formulations is critical. Beneficial modulation of the human microbiota by using these nutritional and biotherapeutic strategies holds considerable promise as next-generation drugs, vaccinomics, and metabolic agents and in novel food discovery.

Precepting and mentoring needs of nursing faculty and clinical instructors: fostering career development and community.

A descriptive survey was conducted to describe (a) perceptions of precepting and mentoring at early-, mid-, and late-career phases and (b) the organization's support of department members' precepting and mentoring needs. Participants were nursing faculty and clinical instructors at a midwestern public university. The Measure of Precepting and Mentoring was developed for this study. Findings indicate that clinical instructors experience greater precepting and mentoring satisfaction than faculty and distance-site department members experience a higher level of satisfaction than main-campus department members. Faculty expressed the most dissatisfaction for late-career mentoring and organizational culture and outcomes. From the qualitative data, three themes emerged: (a) a need for precepting and mentoring that changes with time, (b) a lack of an organizational precepting and mentoring philosophy and supporting mechanisms, and (c) the feeling of together but separate. A model of precepting and mentoring emerged from our study.

In search of the loci for sex differences in throwing: the effects of physical size and differential recruitment rates on high levels of dart performance.

Contemporary accounts of sex differences in perceptual-motor performance differ in their emphasis on nature and nurture. Study 1 examined the effect of extensive training on one of the largest sex differences, namely accuracy in dart throwing, and found that physical differences in height and reach could not explain sex differences in regional/national level dart players. Study 2 rejected accounts of sex differences based on participation rates by showing that male players recruited from a relatively small pool of club players were superior to the best female players selected from a much larger pool at the international level. Alternative accounts of the source of sex differences in darts, based on male and female players' differential development and practice histories, are discussed.

Pancreatic enzyme therapy and clinical outcomes in patients with cystic fibrosis.

OBJECTIVE: To assess the relationship between pancreatic enzyme therapy (PET) and the clinical outcomes of growth, abdominal pain, constipation, gassiness, and number of stools in cystic fibrosis (CF). STUDY DESIGN: Patients (n = 1215) >4 weeks of age from 33 Cystic Fibrosis Foundation accredited sites who had a sweat chloride >60 mmol/L or two CF-causing mutations were enrolled using a proportionate sampling strategy in a nonblinded study. Patients submitted a stool sample and completed a questionnaire. The study coordinator also completed a questionnaire for each patient. Enzyme dosing and growth, abdominal pain, gassiness, constipation, and number of stools were compared. RESULTS: Of the 1215 enrolled patients, 1131 (93.1%) were prescribed PET. Only 14.9% had pancreatic function assessed before enrolling in this study. Stool elastase-1 analysis identified 1074 (89%) patients as pancreatic insufficient (PI). There was no association between PET and the outcomes: growth, abdominal pain, gassiness, constipation, and number of stools. CONCLUSION: PET dose is not correlated with growth or gastrointestinal symptoms. More sensitive outcome measures of the effectiveness of PET in patients with CF are needed to guide treatment of PI.

Use of fecal elastase-1 to classify pancreatic status in patients with cystic fibrosis.

OBJECTIVE: To test the hypothesis that some patients with cystic fibrosis (CF) are misclassified as pancreatic insufficient, using fecal elastase-1 (FE-1) to define pancreatic status. STUDY DESIGN: Subjects with CF at 33 CF centers filled out questionnaires and submitted a stool specimen that was analyzed for FE-1. Subjects taking pancreatic enzyme supplements (PES) were asked to discontinue them and perform a 3-day fecal fat balance study if their FE-1 was >200 microg/g stool and they had never had pancreatitis. RESULTS: The median value for FE-1 in 1215 subjects was 0 microg/g stool (range, 0-867). There was a significant difference between patients who had been prescribed PES (n=1131) and those who had FE-1 <200 microg/g stool (n=1074; P<.0001). Sixty-seven subjects met criteria for discontinuation of PES. The mean coefficient of fat absorption for these subjects was 96.1%. CONCLUSIONS: FE-1 is an accurate, easily obtained screening test to classify pancreatic status in patients with CF. This information is important for prognostication, treatment, and to avoid misclassification in clinical research. Measurement of FE-1 should become a standard of care for patients with CF.

In vivo effects of bifidobacteria and lactoferrin on gut endotoxin concentration and mucosal immunity in Balb/c mice.

The aim of the present study was to examine the effects of oral supplementation of newborn Balb/c mice with bifidobacteria (B. infantis, B. bifidum) and iron-free apo-lactoferrin (bovine, human) on gut endotoxin concentration and mucosal immunity. Endotoxin concentration was measured in ileocecal filtrates at 7, 14, 21, and 28 days postdelivery by a quantitative limulus amebocyte lysate test. While endotoxin levels in bifidobacteria-fed mice showed a steady rise over time, they were consistently lower than that observed in control animals. Results of lactoferrin supplementation varied depending on the specific time point, but overall by day 28, all treatment groups showed lower intestinal endotoxin concentrations compared to saline fed animals. Neither bifidobacteria nor lactoferrin stimulated an increase in B or T cells, or in cytokine production (IL-6, TNF-alpha, INF-gamma), in Peyer's patches as measured by flow cytometry. Bifidobacteria and lactoferrin were well tolerated as dietary supplements and showed promising potential to reduce gut endotoxin levels.

Improvements in immunization compliance using a computerized tracking system for inner city clinics.

Vaccination compliance rates were calculated for 1995 to 2001 for enrolled patients, based on the Centers for Disease Control and Prevention guidelines and age-appropriate vaccine schedules. The results reported here indicate computerized tracking with the Doctor's Pediatric Immunization Program (Dr. PIP) maintained vaccine compliance rates (> 90%) in healthy and immunocompromised children at 2 months and 12 months of age. Instituting the computerized system has yielded nearly optimal results in both indigenous inner-city clinics. Despite the efficient progress made by automated tracking, the results for specific vaccine strategies (Varicella) and target groups (human immunodeficiency virus, high-risk indigent populations) may require on-going and intensive educational efforts to achieve optimization levels.

In vitro growth responses of bifidobacteria and enteropathogens to bovine and human lactoferrin.

A series of in vitro experiments was performed to test the ability of bovine and human lactoferrin to influence the growth of the gram-positive probiotic bacteria, Bifidobacterium bifidum, Bifidobacterium infantis, and Lactobacillus acidophilus, as well as the gram-negative enteric bacteria, E. coli O157:H7 and Salmonella typhimurium. None of the lactoferrin preparations stimulated the growth of the tested strains. However, iron-free apo-lactoferrin (bovine and human) and 66% iron-saturated bovine lactoferrin dramatically slowed the growth of E. coli O157:H7 in single culture experiments, while 98% iron-saturated preparations had no effect. In coculture experiments of B. infantis and E. coli, the iron-limited preparations of lactoferrin also slowed the growth of the latter without inhibiting the bifidobacteria. These results suggest that lactoferrin in iron-limited forms may have the potential to be combined with probiotic bacteria in biotherapeutic products, which could help balance human gut microflora and limit the overgrowth of certain enteric microorganisms.

Immune responses in rhesus rotavirus-challenged BALB/c mice treated with bifidobacteria and prebiotic supplements.

Bifidobacterium species (B. bifidum and B. infantis), with or without prebiotic compounds (arabino-galactan, short-chain fructo-oligosaccharide, iso-malto-dextrins), were orally fed to Balb/c pups (n = 192) to evaluate their potential synergistic effects on modulating the course of rhesus rotavirus (RRV) infection, as well as their ability to mediate the associated mucosal and humoral immune responses. Rotavirus-specific IgA and IgG in serum, rotavirus antigen, and specific IgA in feces were measured by ELISA. Mucosal total IgA and IgG levels were determined in Peyer's patches by flow cytometry. Significantly delayed onset (p = 0.001) and early resolution (p < 0.001) of diarrhea were observed in bifidobacteria-treated, RRV-infected mice compared with RRV-infected control mice. Supplementation with prebiotic compounds did not shorten the clinical diarrhea course more than that observed with bifidobacteria treatment alone. Rotavirus-specific IgA in feces was 16-fold elevated on d 5 postinfection in bifidobacteria-treated, RRV-infected mice compared with the RRV-infected alone group. In addition, the level of rotavirus-specific IgA in serum was four-fold higher in bifidobacteria-treated, RRV-infected litters versus mice challenged with RRV alone on 28 and 42 d postinfection. No enhancement of the immune response was found in RRV-infected mice that were treated with both bifidobacteria and prebiotic compounds over those treated with bifidobacteria only. The findings suggest that bifidobacteria may act as an adjuvant by modulating early mucosal and strong humoral rotavirus-specific immune responses, and mitigate severity of rotavirus-induced diarrhea.

Bacterial toxins and enteral feeding of premature infants at risk for necrotizing enterocolitis.

Bacterial translocation and enteral feeding are factors implicated in neonatal necrotizing enterocolitis (NEC) in the preterm infant. A cohort of 60 preterm low birth-weight (LBW) infants (600-1,600 g at birth) consecutively admitted to the neonatal intensive care unit (NICU; N = 183) were prospectively followed to evaluate the role of bacterial endotoxins (lipopolysaccharides) and enteral feeding in the development of NEC. Stage I NEC was identified in 14/60 (23%) infants. In all, 15% (9/60) of infants followed, which represented roughly 5% of higher risk, LBW infants admitted to the NICU, progressed to Stage II or III NEC disease. Infants not enterally fed (nothing by mouth [NPO]) were at greatest risk of developing NEC. No infant who was breast milk fed progressed to Stage II or III NEC. The protective effect of breast milk was most evident when compared with the combined group of NPO or formula-feeding infants per person-week at risk (RR = .15, P < .04). Toxin-producing bacteria and endotoxin levels in stool filtrates predicted early and advanced stages of NEC disease. Cytokine concentrations (interleukin-6 [IL-6]) in stool appeared of limited value in reflecting mucosally limited disease in the gastrointestinal tract. Overgrowth of toxin-producing bacteria and their toxin products may adversely affect gut barrier function; monitoring endotoxin concentrations in stool filtrates may be most clinically useful in NPO and formula-fed infants identified at risk of developing NEC. Am. J. Hum. Biol. 10:211-219, 1998. © 1998 Wiley-Liss, Inc.