A systematic review and meta-analysis of interventions to increase physical activity in children and adolescents with intellectual disabilities.

BACKGROUND: Increasing physical activity (PA) through intervention can promote physical and mental health benefits in children and adolescents. However, children and adolescents with intellectual disabilities (ID) have consistently been shown to engage in low levels of PA, which are insufficient for long-term health. Despite this, little is known about the effectiveness of interventions to increase PA in children and adolescents with ID. The aims of this study were therefore to systematically review how effective interventions are at increasing PA levels in children and adolescents with ID and to further examine what components have been used in these interventions. METHOD: A systematic search of MEDLINE, EMBASE, Education Resources Information Center, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, Cochrane Central Register for Controlled Trials and International Standard Randomised Controlled Trial Number trials registry was conducted (up to July 2016). Articles were included if they met the following eligibility criteria: children and adolescents (<18 years) with ID, measurement of PA at baseline and post-intervention and intervention studies. Effect sizes were calculated as standardised mean difference (d) and meta-analysis calculated between intervention and no treatment control intervention. RESULTS: Five studies met the eligibility criteria and were included in the review. Study design, methodological quality and intervention components were varied. Interventions did not support sufficient changes in PA to improve health. The meta-analysis demonstrated that intervention groups were not more effective at increasing PA levels post-intervention (d: 2.20; 95% CI -0.57 to 0.97) compared with control. However, due to a decrease in PA in the control intervention, a moderate significant effect was demonstrated at follow-up (d: 0.49; 95% CI 0.14 to 0.84). CONCLUSIONS: There is a lack of studies which aim to increase PA levels in children and adolescents with ID, with current interventions ineffective. Future studies are required before accurate recommendations for appropriate intervention design and components can be made.

Ocular penetration of pilocarpine in rabbits.

Aqueous humor pilocarpine hydrochloride concentration was measured at 15, 30, 60, and 120 minutes after instillation in the rabbit eye of a radioactively labeled 2% pilocarpine solution in various vehicles. Maximum concentrations were found with a vehicle containing 1.67% polyvinylpyrrolidone and other water-soluble polymers (Adsorbotears) and 1% hydroxypropyl methylcellulose. These produced pilocarpine concentrations during the first two hours after administration three times greater than those found with either saline, 1.4% polyvinyl alcohol, or 0.5% hydroxypropyl methylcellulose. Benzalkonium chloride, 0.01%, enhanced pilocarpine penetration into the aqueous by as much as 50% at all time intervals. The vehicle viscosity was unrelated to efficacy of pilocarpine penetration into the aqueous. The equally effective 1% hydroxypropyl methylcellulose and Adsorbotears have viscosities of 112 and 20 centistokes, respectively, while 0.5% hydroxypropyl methylcellulose (13 centistokes), 1.4% polyvinyl alcohol (3 centistokes), and sodium chloride solution (0.85 centistokes) are much less efficacious.

Corneal membrane water permeability as a function of temperature.

Osmotically driven water flow across the corneal epithelium and endothelium has been measured as a function of temperature. For both membranes deviations from a single straight-line relationship are found in a logarithmic plot of hydraulic conductivity against 1/T. Both membranes show a high (14 to 16 kcal per mole) apparent activation energy at temperatures between 23 degrees C. and 5 degrees C. At higher temperatures, between 23 degrees C. and 37 degrees C., the apparent activation energy falls to 5.7 and 9.3 kcal per mole for the epithelium and endothelium, respectively. The low value for the apparent activation energy for water crossing the epithelium and endothelium at normal corneal temperatures presumably reflects water passage through water-filled channels.