Sport Participation for Adults Aged 50 + Years: A Socioecological Analysis.

Sport participation can play a key role in older adults' successful aging as it provides an enjoyable opportunity for leisure-time physical activity. Research focusing on the benefits of sport participation in later life and facilitators for involvement has been increasing in the past several years. Drawing on the socioecological model, this study investigated select socioecological factors that predict older adults' sport participation from a holistic perspective. An online survey provided quantitative data from 1203 adults aged 50 and older across the United States. Results from logistic regression analyses showed that personal characteristics, individual behavior, environment/policy, and life course effects were significant predictors of sport participation in later life. The findings in this study enhance our understanding of factors related to older adults' sport participation and are also of value to practitioners seeking to promote sport participation among older adults.

Cerebral visual impairment-related vision problems in primary school children: a cross-sectional survey.

AIM: To estimate how many children in mainstream primary schools have cerebral visual impairment (CVI)-related vision problems and to investigate whether some indicators might be useful as red flags, if they were associated with increased risk for these problems. METHOD: We conducted a survey of primary school children aged 5 to 11 years, using whether they were getting extra educational help and/or teacher- and parent-reported behaviour questionnaires to identify children at risk for CVI. These and a random 5% sample were assessed for CVI-related vision problems. We compared the usefulness of potential red flags using likelihood ratios. RESULTS: We received questionnaires on 2298 mainstream-educated children and examined 248 children (152 [61%] males, 96 females [39%]; mean age 8y 1mo, SD 20mo, range 5y 6mo-11y 8mo). We identified 78 out of 248 children (31.5% of those examined, 3.4% of the total sample), who had at least one CVI-related vision problem. The majority (88%) were identified by one or more red flag but none were strongly predictive. Fewer than one in five children with any CVI-related vision problem had reduced visual acuity. INTERPRETATION: Children with CVI-related vision problems were more prevalent than has been appreciated. Assessment of at-risk children may be useful so that opportunities to improve outcomes for children with CVI-related vision problems are not missed.

Hydrolysis of particulate organic matter from municipal wastewater under aerobic treatment.

Hydrolysis of particulate organic matter is known to be a limiting step in biological wastewater treatment. In this work, we used an experimental set-up, which allowed the parallel observation of hydrolysis product formation on the one side and utilization on the other side. The hydrolysis products are characterized by using size exclusion chromatography with online carbon and UV (254 nm) detection. The used particles (size: 25-250 µm) originated from municipal wastewater. Here, it is shown that the concentration of high molecular weight organic matter increases over the first three days. During this time, bacteria grow and produce the required enzymes to perform the further degradation. The oxygen utilization rate (OUR) on the other side continuously develops, confirming the presence of easily biodegradable organic matter. In parallel, the amount of bacteria and extracellular polymeric substances (EPS) undergoes a certain dynamics, which was visualized by using confocal laser scanning images.

A membrane biofilm reactor for hydrogenotrophic methanation.

Biomethanation of CO2 has been proven to be a feasible way to produce methane with the employment of H2 as electron source. Subject of the present study is a custom-made membrane biofilm reactor for hydrogenotrophic methanation by archaeal biofilms cultivated on membrane surfaces. Reactor layout was adapted to allow for in situ biofilm analysis via optical coherence tomography. At a feeding ratio of H2/CO2 of 3.6, and despite the low membrane surface to reactor volume ratio of 57.9 m2 m-3, the maximum methane production per reactor volume reached up to 1.17 Nm3 m-3 d-1 at a methane content of the produced gas above 97% (v/v). These results demonstrate that the concept of membrane bound biofilms enables improved mass transfer by delivering substrate gases directly to the biofilm, thus, rendering the bottleneck of low solubility of hydrogen in water less drastic.

Virulence Characteristics of mecA-Positive Multidrug-Resistant Clinical Coagulase-Negative Staphylococci.

Coagulase-negative staphylococci (CoNS) are an important group of opportunistic pathogenic microorganisms that cause infections in hospital settings and are generally resistant to many antimicrobial agents. We report on phenotypic and genotypic virulence characteristics of a select group of clinical, mecA-positive (encoding penicillin-binding protein 2a) CoNS isolates. All CoNS were resistant to two or more antimicrobials with S. epidermidis strain 214EP, showing resistance to fifteen of the sixteen antimicrobial agents tested. Aminoglycoside-resistance genes were the ones most commonly detected. The presence of megaplasmids containing both horizontal gene transfer and antimicrobial resistance genetic determinants indicates that CoNS may disseminate antibiotic resistance to other bacteria. Staphylococcus sciuri species produced six virulence enzymes, including a DNase, gelatinase, lipase, phosphatase, and protease that are suspected to degrade tissues into nutrients for bacterial growth and contribute to the pathogenicity of CoNS. The PCR assay for the detection of biofilm-associated genes found the eno (encoding laminin-binding protein) gene in all isolates. Measurement of their biofilm-forming ability and Spearman's rank correlation coefficient analyses revealed that the results of crystal violet (CV) and extracellular polymeric substances (EPS) assays were significantly correlated (ρ = 0.9153, P = 3.612e-12). The presence of virulence factors, biofilm-formation capability, extracellular enzymes, multidrug resistance, and gene transfer markers in mecA-positive CoNS clinical strains used in this study makes them powerful opportunistic pathogens. The study also warrants a careful evaluation of nosocomial infections caused by CoNS and may be useful in studying the mechanism of virulence and factors associated with their pathogenicity in vivo and developing effective strategies for mitigation.

Physical activity levels among rural adolescents with a history of ankle sprain and chronic ankle instability.

Ankle sprains and their common sequalae are thought to negatively affect physical activity levels and health-related quality of life among active populations, but limited evidence has described this among younger populations. This study aimed to determine the prevalence rate of ankle sprain and chronic ankle instability among rural adolescents and subsequently compare their physical activity levels based on ankle injury status. The study was conducted in a rural high school in North Carolina. High school students completed an online survey that assessed ankle injury history, perception of ankle instability and function, and physical activity. Respondents were categorized into one of four groups based on ankle injury history and complaints of instability: 1) uninjured (no history of injury); 2) unstable (history of injury >1 year and recurrent instability); 3) copers (history of injury >1 year and no recurrent instability); and 4) potentially unstable (injury within the past year). Frequency of physical activity was compared across groups using analysis of variance, Kruskall-Wallis test (α = 0.05), and responses to activity type were assessed using chi-square. Physical activity was found to differ significantly between the four groups [Formula: see text] with unstable respondents reporting more physical activity than uninjured respondents (unstable = 4706.05 ± 4610.56 MET-minutes/week; uninjured = 2592.93 ± 2946.02 MET-minutes/week). No differences were found between other groups. Despite injury history and sensations of instability, respondents with chronic ankle instability reported greater physical activity levels than uninjured participants. As this is contrary to pre-existing hypotheses, it is possible that continued physical activity after injury among adolescents may contribute to deleterious outcomes such as increased frequency of chronic instability.

A Life Course Examination of Women's Team Sport Participation in Late Adulthood.

This study contributes to the fields of aging and physical activity by applying the key principles of the life course perspective to investigate women's team sport participation experience in late adulthood. Through focus groups, data were collected from six competitive softball teams of women (N = 64) ranging from 55 to 79 years old. Data were audio recorded, transcribed verbatim, and analyzed for themes related to the life course principles of historical context and place, social embeddedness, agency, as well as trajectories and timing. A key study finding was that the women experienced cultural lag and age-related barriers to resources when playing competitive softball in late adulthood. In addition, the network of shared relationships occupied by these women had both positive and negative influences on their participation in competitive sports. Study findings can help inform services and programs at the local community level aimed at enhancing women's physical activity and health in late adulthood.

Community structure of a sulfate-reducing consortium in lead-contaminated wastewater treatment process.

This study evaluated the capacity to remove lead by an indigenous consortium of five sulfate-reducing bacteria (SRB): Desulfobacterium autotrophicum, Desulfomicrobium salsugmis, Desulfomicrobium escambiense, Desulfovibrio vulgaris, and Desulfovibrio carbinolicus, using continuous moving bed biofilm reactor systems. Four continuous moving bed biofilm reactors (referred as R1-R4) were run in parallel for 40 days at lead loading rates of 0, 20, 30 and 40 mg l-1 day-1, respectively. The impact of lead on community structure of the SRB consortium was investigated by dsrB gene-based denaturing gradient gel electrophoresis (dsrB-based DGGE), fluorescence in situ hybridization (FISH) and chemical analysis. These results indicated that D. escambiense and D. carbinolicus were dominant in all analyzed samples and played a key role in lead removal in R2 (20 mg l-1 day-1) and R3 (30 mg l-1 day-1). However, in R4 (40 mg l-1 day-1), these two strains were barely detected by FISH and dsrB-based DGGE. As a result, SRB activity was severely affected by lead toxicity. High lead removal efficiencies of lead (99-100%) were observed in R2 and R3 throughout the operation, whereas that in R4 was significantly decreased (91%) after 40 days of operation. This data strongly implied that the investigated SRB consortium might have potential application for lead removal. Moreover, to improve the efficiency of the lead treatment process, the lead loading rates below the inhibitory level to SRB activity should be selected.

Ophthalmomyiasis interna masquerading as orbital cellulitis.

Ophthalmomyiasis interna posterior is a rare condition caused by the invasion of the ocular posterior segment by the larval form of certain flies in the order Diptera. The main clinical features are reduced visual acuity, intense posterior uveitis, and neuroretinitis. Treatment of this condition is predominantly surgical, including argon laser photocoagulation for subretinal larva and pars plana vitrectomy for intravitreal infection. We report a case of ophthalmomyiasis interna posterior in a 12-year-old girl that masqueraded as orbital cellulitis and was successfully treated with Nd:YAG laser photodisruption.

Use of MultiColor imaging in the assessment of suspected papilledema in 20 consecutive children.

PURPOSE: To investigate the use of MultiColor Scanning Laser Imaging as an adjunct to traditional imaging modalities in the assessment of children with suspected disk swelling. METHODS: In this study of 20 consecutive children with suspected papilledema, MultiColor imaging was performed on all patients in addition to fundus examination, fundus autofluorescence, disk spectral domain optical coherence tomography (SD-OCT), and disk retinal nerve fiber layer thickness (RNFL) measurement. Diagnoses were determined in all 20 patients, and all images were evaluated by a medical retina specialist. RESULTS: Of the 20 cases (average age 11 years [range, 5-16 years]; 10 males), papilledema was confirmed in 11 (55%) and pseudopapilledema diagnosed in 9 (45%). Of pseudopapilledema cases, there were 4 cases of optic disk drusen, 2 hypermetropic disks, 2 "crowded disks," and 1 anomalous disk. In patients with true papilledema, on the combined MultiColor image, a green shift in the form of an elevated green ring was seen consistently. This ring was also hyperreflective on the blue and green images and surrounded a central "shadow," which was seen best on near infrared reflectance (NIR). The disk margins and vasculature were obscured on the combined, green, blue, and NIR images. These changes were not present in the pseudopapilledema cases. CONCLUSIONS: MultiColor imaging of disks with papilledema shows characteristic changes that may prove useful in differentiating true papilledema from pseudopapilledema. It is therefore a useful adjunct to traditional disk imaging modalities in assessing children with suspected disk swelling.

Amblyopia in children (aged 7 years or less).

INTRODUCTION: Amblyopia is reduced visual acuity not immediately correctable by glasses, in the absence of ocular pathology. It is commonly associated with squint (strabismus) or refractive errors resulting in different visual inputs to each eye during the sensitive period of visual development (aged <7-8 years). The cumulative incidence is estimated at 2% to 4% in children aged up to 7 years. METHODS AND OUTCOMES: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of medical treatments for amblyopia in children aged 7 years or less? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). RESULTS: At this update, searching of electronic databases retrieved 70 studies. After deduplication and removal of conference abstracts, 51 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 37 studies and the further review of 14 full publications. Of the 14 full articles evaluated, two systematic reviews were updated and three RCTs and two follow-up studies were added at this update. We performed a GRADE evaluation for nine PICO combinations. CONCLUSIONS: In this systematic overview we categorised the efficacy for three interventions, based on information about the effectiveness and safety of glasses, occlusion, or penalisation with atropine.

Electroretinogram assessment of children with sensorineural hearing loss: implications for screening.

BACKGROUND: The guidelines of the National Deaf Children's Society recommend that children with sensorineural hearing loss (SNHL) be routinely screened for ophthalmological problems and suggest electroretinography (ERG) to exclude Usher syndrome. The present study reports the nature and prevalence of abnormal ERG findings in a cohort of children with SNHL undergoing ERG with the aim of identifying risk factors for the diagnosis of Usher syndrome. METHODS: The medical records of children (<18 years of age) with SNHL referred for ERG at Moorfields Eye Hospital, London, between January 2009 and December 2011 were retrospectively reviewed. Patients were included if they had been referred with SNHL by an audiological medicine consultant and the primary indication for electrodiagnostic testing was possible Usher syndrome. RESULTS: A total of 84 cases met inclusion criteria of which 13 (15%) had ERG findings showing rod-cone dysfunction consistent with a diagnosis of Usher syndrome. Two patients with retinal pigmentary changes had normal ERGs and were diagnosed with rubella retinopathy based on the clinical findings. Risk factor analysis showed that age of ≥8 years at the time of ERG, sex, and bilateral hearing loss were not predictive of a diagnosis of Usher syndrome. However, the presence of or referral for cochlear implants, having relevant symptoms and/or clinical signs consistent with a retinal dystrophy, and profound hearing loss were all highly predictive. CONCLUSIONS: ERG is a useful diagnostic tool in children with SNHL and should be performed in children with SNHL who have cochlear implants and/or have signs or symptoms of retinal dystrophy. A focused approach could have potential cost-saving benefit.

Cost-effectiveness analysis of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures.

BACKGROUND/AIMS: The inability of some children to tolerate detailed eye examinations often necessitates general anaesthesia (GA). The objective was to assess the incremental cost effectiveness of paediatric eye examinations carried out in an outpatient sedation unit compared with GA. METHODS: An episode of care cost-effectiveness analysis was conducted from a societal perspective. Model inputs were based on a retrospective cross-over cohort of Canadian children aged <7 years who had both an examination under sedation (EUS) and examination under anaesthesia (EUA) within an 8-month period. Costs ($CAN), adverse events and number of successful procedures were modelled in a decision analysis with one-way and probabilistic sensitivity analysis. RESULTS: The mean cost per patient was $406 (95% CI $401 to $411) for EUS and $1135 (95% CI $1125 to $1145) for EUA. The mean number of successful procedures per patient was 1.39 (95% CI 1.34 to 1.42) for EUS and 2.06 (95% CI 2.02 to 2.11) for EUA. EUA was $729 more costly on average than EUS (95% CI $719 to $738) but resulted in an additional 0.68 successful procedures per child. The result was robust to varying the cost assumptions. CONCLUSIONS: Cross-over designs offer a powerful way to assess costs and effectiveness of two interventions because patients serve as their own control. This study demonstrated significant savings when ophthalmological exams were carried out in a hospital outpatient clinic, although with slightly fewer procedures completed.

Does building a greenway promote physical activity among proximate residents?

BACKGROUND: Previous research has observed a positive correlation between having greenways or trails proximate to homes and the physical activity behaviors among residents. Few studies using a pre-post research design have been conducted, and each has pointed to the need for more rigorous studies which incorporate an appropriate control group. METHODS: Residents from households living within 1 mile of a proposed greenway and those from a control neighborhood located between 2 and 3 miles of the proposed greenway were randomly selected to participate in the study. Participants were mailed a survey before the onset of construction and again 1 year after the trail was opened. Outcomes were the number of days during the previous week that respondents reported participating in walking, moderate activity, and vigorous activity. RESULTS: Repeated measures analyses of variance indicated no significant differences between the experimental and control groups in days of walking, moderate activity, or vigorous activity before and after the greenway was constructed. CONCLUSIONS: Findings suggest that building a greenway did not affect the physical activity behaviors of proximate residents. Other studies should consider different trail types from a variety of settings to determine whether physical activity behavior changes may be context specific.

Improving the physical activity and nutrition environment through self-assessment (NAP SACC) in rural area child care centers in North Carolina.

OBJECTIVE: To determine if child care centers in rural, Western North Carolina met recommendations for nutrition and physical activity, if focusing on nutrition and physical activity practices and policies was effective in improving the center environment, and if differences existed between centers affiliated or unaffiliated with schools. METHODS: Of 33 child care centers in three counties, 29 submitted mini-grant requests and participated in a pre-post evaluation using Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC). NAP SACC assesses compliance for nutrition and physical activity recommendations and standards. Between October 2011 and April 2012, centers participated in workshops and goal setting specific to nutrition and physical activity. RESULTS: At baseline, over 95% of the centers met all recommendations. However, post-intervention, Wilcoxon Signed Ranks Test (p<0.05) indicated significant improvement across center types in five out of 37 nutrition and seven out of 17 physical activity standards following the intervention. Centers unaffiliated with schools made significant changes in ten nutrition standards, while those affiliated with schools improved in only two standards and decreased on one standard. CONCLUSION: Overall, rural child care centers in Western North Carolina were meeting standards, they were still able to strengthen policies and practices by following NAP SACC. This was especially true for centers unaffiliated with schools. Continued financial support may assist centers in sustaining increased physical activity in children.

Survey of policy for MRSA screening in English cataract surgical units and changes to practice after updated National guidelines.

BACKGROUND: National guidelines on MRSA (methicillin-resistant Staphylococcus aureus) screening policy in England have changed on a number of occasions, but there is limited data on its influence at a local level. The aim of this study was to determine if changes in National policy influenced preoperative screening of cataract patients for MRSA. METHODS: A structured telephone survey was conducted on all 133 ophthalmology units in England in 2004 and again in 2007 for the initial responders, after a change in national policy. RESULTS: A total of 74 units (56%) responded in 2004 and 71 units (96% of initial respondents) in 2007. In 2004, 57% of units screened for MRSA. They screened groups at high risk of carriage, including patients with previous MRSA (93%) and patients from Nursing homes (21%). Swab sites included the nose (100%), eyes (31%) and perineum (62%). In 2007, there was no significant change in the number of units that screened for MRSA (57% vs 66%; p = 0.118; McNemar test). However, more units screened for MRSA in patients from nursing/residential homes (21% vs 51%; p = 0.004, McNemar test), and in patients who had recent admission to hospital (12% vs 36%; p = 0.003). In the second survey, 3 units (6%) now screened patients who were close relatives of MRSA carriers. CONCLUSION: This survey has highlighted inconsistences in MRSA screening practice of day-case cataract surgery patients across England after 2 major national policy changes. A change in DoH policy only led to more units screening patients for MRSA from high risk groups.

Stakeholder perceptions of obesity-prevention strategies: a comparison of geographically diverse rural counties.

Understanding barriers and facilitators to strategies directed at obesity-prevention policy change, particularly in rural, southern US counties where obesity is more prevalent, is important so that strategies deemed most winnable can be pursued. As such, community stakeholders and policy makers were interviewed using the Centers for Disease Control and Prevention's Common Community Measures for Obesity Prevention Assessment in 2 rural, geographically diverse regions of North Carolina. Stakeholder interviews revealed many similarities despite population differences and unique geographic challenges to each region. In both Western and Eastern North Carolina, strategies involving increasing opportunities for physical activity were deemed the most winnable, whereas strategies incentivizing businesses to locate in underserved areas and limiting advertisements of unhealthy food and beverages were deemed the least winnable. Differences among Western and Eastern North Carolina regions revolved around zoning, geographic constraints, and topographically influenced local food strategies. These findings add to the literature by systemically identifying similarities and differences among geographically diverse rural communities.

Utilisation of an outpatient sedation unit in paediatric ophthalmology: safety and effectiveness of chloral hydrate in 1509 sedation episodes.

OBJECTIVE: To report the largest study on the safety and effectiveness of sedation in paediatric ophthalmology in a nurse-led outpatient sedation unit. DESIGN: Retrospective cohort study reviewing all children who underwent sedation from January 2006 to December 2010. Patients were sedated with 80 mg/kg of chloral hydrate (CH) given orally with top up dose given at half dose as required. All demographic data, sedation and procedure duration, sedation success and adverse events were recorded. Univariate and multiple regression analyses were performed to assess factors associated with success and complications. RESULTS: Data was collected for 1509 sedation episodes. More boys were sedated compared with girls (56.3% vs 43.7% p=0.0003) with an average age of 23.86 months and weight of 11.76 kg. A higher proportion of patients had an American Society of Anaesthesiologists status of II than I (58.5%:41.5%, p=0.0001). Successful sedation was obtained in 96.69% of children with 4.77% requiring a top up dose to achieve this. The average sedation duration was 53.4 min (SD=21.5) with an average of 1.7 procedures performed; the most common being a detailed examination (93.5%) and electroretinogram (45.1%). Adverse events included paradoxical reaction (1.33%), oxygen desaturation (0.99%) and vomiting (0.53%). There were no serious complications or hospital admission. Multiple logistic regression analysis found weight greater than 15 kg and needing a top up dose to be significant risk factors for Failure (OR=2.49 and 8.69, respectively) and Adverse events (OR=2.1 and 3.97, respectively). Sex and American Society of Anesthesiologists Physical Status score did not significantly affect outcomes. CONCLUSIONS: CH sedation allows detailed examination and investigations in the majority of children with few side effects. Patients over 15 kg and need for a top up dose are risk factors for failure and adverse events. This is the largest study in the current literature looking at the use of CH sedation in ophthalmology and confirms its safety and effectiveness.

Association of available parkland, physical activity, and overweight in America's largest cities.

OBJECTIVE: To examine associations between the densities of available parkland, parkland provided per capita, and levels of physical activity (PA) and overweight in urban United States. DESIGN: Cross-sectional correlation research using data drawn from the Trust for Public Land's 2010 City Park Facts and The Behavioral Risk Factor Surveillance System (BRFSS). City Park Facts is a report containing "basic information on urban park systems--from acreage, to facilities, to staffing, to budgets, to usership, and more" for America's 85 largest cities. The Behavioral Risk Factor Surveillance System is a state-based surveillance system that collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. SETTING: Sixty-seven metropolitan statistical areas in the United States that provided data for both reports. PARTICIPANTS: Randomly selected adults aged 18 years and older who participated in the 2009 Behavioral Risk Factor Surveillance Survey in the 67 metropolitan statistical areas. MAIN OUTCOME MEASURE(S): Total parkland per acre of metropolitan area was correlated to inactivity, engaging in recommended levels of moderate or vigorous PA, engaging in recommended levels of vigorous PA, and body weight. Parkland acreage per 1000 residents was correlated to these same variables. Multilevel models considered these relationships while controlling for race, family income, and age of respondents and accounting for clustering by metropolitan statistical area. RESULTS: There were significant, positive correlations between park density and PA (r(s) = 0.37, n = 67, P < .01) and between park density and exercise (r(s) = 0.35, n = 67, P < .01), and a negative correlation between park density and being above normal weight (r(s) = -0.32, n = 67, P < .01). Adjusted multilevel models showed that parkland density in the highest versus lowest quartile was associated with significantly higher odds of meeting PA guidelines (aOR = 1.19, 95% CI: 1.08-1.30) and reduced odds of being overweight/obese (aOR = 0.85, 95% CI: 0.76-0.95). CONCLUSIONS: Each of these findings substantiates the need for providing parkland in a community. As such, this research helps to support the notion that the development of a strong park system may lead to positive PA and health outcomes for that community.

The impacts of building a greenway on proximate residents' physical activity.

BACKGROUND: A significant association has been identified between physical activity and proximity to greenways. However, residents more likely to be active may have selected to live near existing greenways. The purpose of this study was to determine whether development of a new greenway has the potential to increase activity levels of existing, proximate residents. METHODS: In 2008, survey data were collected before and after 5 miles of greenway were added to an existing greenway. RESULTS: When comparing residents living nearest (≤ .50 miles) the new greenway section with those living further (.51-1.0 miles), days spent walking and participating in moderate physical activity increased. Despite mean increases, no significant interactions were detected. CONCLUSIONS: Although evidence is inconclusive, apparent increases in walking and moderate activity suggest development of a greenway proximate to residents' homes is likely to have a positive effect on participation levels. Additional research is needed to address article limitations.