A comparison of physical activity, physical fitness levels, BMI and blood pressure of adults with intellectual disability, who do and do not take part in Special Olympics Ireland programmes: Results from the SOPHIE study.

People with an intellectual disability are less physically active, live more sedentary lives, have lower fitness levels and are more likely to be overweight or obese than the general population. No evidence exists on the impact of participation in Special Olympics Ireland (SOI) on physical activity and physical fitness levels. Adults with intellectual disabilities (16-64 years) were recruited from services and SOI clubs. Physical measures included waist circumference, height, weight, blood pressure, heart rate and 6-min walking test. Self-report questionnaires gathered data on physical activity levels. Actigraph (GT3X) accelerometers were used to gain an objective measure of physical activity. SOI participants accumulated more moderate to vigorous physical activity per day, had higher fitness levels and more positive health profile scores than those not taking part in SOI. SOI has the potential to make a positive difference to people's physical health and subsequently their overall health and well-being.

Journeys to Jamaica: A Healthy Dose of Culture, Competence, and Compassion.

Nurse practitioner and doctor of nursing practice students gain cultural awareness and primary care experience on biannual medical mission trips to Jamaica. Faith-based Molloy College's partnership with professional medical volunteers enables students to apply clinical skills, express compassion, and gain interprofessional experience. Volunteers provide care and education for the high prevalence of noncommunicable conditions found in Jamaica. The program enjoys a positive relationship with Jamaica's Ministry of Health; a research study will assess impact on students and patients.

An examination of the nutritional intake and anthropometric status of individuals with intellectual disabilities: Results from the SOPHIE study.

The prevalence of obesity appears greater in people with intellectual disabilities than those in the general population. This study aimed to examine the nutritional intake and anthropometric status of individuals with intellectual disabilities. Participants aged 16-64 years were recruited from intellectual disability service provider organizations ( n = 131). Data were collected using questionnaires; 4-day food dairies and weight, height and waist circumference measurements. Participants' mean body mass index (BMI) was 29.4 kg/m2 ± 6.1, 2.4% were underweight, 22.6% were normal weight, 28.2% were overweight and 46.8% were obese. Having a diagnosis of Down syndrome ( p = 0.03) was associated with increasing BMI. Increasing waist circumference was associated with increasing severity of ID ( p = 0.04). The mean-reported energy intake was 1890 kcal/day. Mean energy intakes from sugar, fat and saturated fat were above recommendations and few participants met micronutrient recommended daily amounts. This study highlights the alarming prevalence of overweight and obesity and poor diet quality of individuals with intellectual disabilities.

People with intellectual disability and their families' perspectives of Special Olympics Ireland: Qualitative findings from the SOPHIE study.

Previous research has highlighted that while involvement in Special Olympics can have benefits for athletes and their families, there can also be many barriers to participation. This qualitative study, which was part of a large mixed-method study, examined the experiences and perspectives of people with intellectual disability, their families and staff who work with them, about Special Olympics Ireland (SOI). A total of 47 participants (15 athletes, 6 non-athletes, 18 family members and 8 staff members) participated in focus group and individual interviews. Supplemental data, gathered as part of the larger study extracted from open-ended survey questions completed by 97 family members also informed this element. Findings revealed four main themes: impact of participation on athletes, impact of involvement on families, barriers to participation and how to enhance participation rates. Involvement in Special Olympics impacted positively on the quality of life of athletes and families. Enhanced availability of user-friendly information and service accessibility were important drivers identified for enhancing participation rates in Special Olympics.

Incorporating the World Health Organization Surgical Safety Checklist into practice at two hospitals in Liberia.

BACKGROUND: The impact of the World Health Organization's Patient Safety Programme's 19-item Surgical Safety Checklist on surgical processes and outcomes was assessed in 2008-2009 at two hospitals in the resource-limited setting of Liberia. METHODS: In the preintervention phase, data were prospectively collected on surgical processes and outcomes from 232 consecutively enrolled patients who were undergoing surgery. In the postintervention phase, data were collected on 249 consecutively enrolled patients after the introduction of the Surgical Safety Checklist. Multivariable logistic regression was used to determine the adjusted association between the introduction of the checklist and surgical process and outcome measures. These analyses were conducted among the pooled data, as well as for data stratified by hospital. RESULTS: The introduction of the checklist was associated with significant (p < 0.05) improvements in terms of overall surgical processes and surgical outcomes. The stratified analysis presented a more nuanced result by hospital. In Hospital 1, the checklist was significantly associated with improved adherence to the composite measure of surgical processes but was not associated with improved surgical outcomes. In contrast, in Hospital 2, it was significantly associated with improved surgical outcomes but was not associated with improved adherence to the composite measure of surgical processes. CONCLUSIONS: Although the implementation of a surgical safety checklist in Liberia was associated with significant improvements in processes and outcomes overall, differences at the hospital level suggest that the checklist's mechanism of improvement may be influenced by the availability of resources needed to complete recommended processes, variation in team functioning, and organizational context.

Interventions to reduce psychosocial disturbance following humanitarian relief efforts involving natural disasters: an integrative review.

Because of the increased level of post-traumatic stress disorder (PTSD) reported post disaster work, it is imperative that governmental and non-governmental agencies consider predisaster training of volunteers in not only clinical skills, but also communication and team building. When these concepts are combined with ongoing support post disaster, a decrease in the frequency and severity of PTSD has been reported. A review of 12 studies examined responses of relief workers to various disaster situations. Experiences were extracted, categorized, and a data reduction model was developed to illustrate the characteristics of the experiences and subsequent interventions that were reported. Three interventions that positively affected the responses of relief workers to disaster experiences emerged: debriefing, team building and preparation.

Boron and aluminum complexes of sterically demanding phosphinimines and phosphinimides.

Reactions of sterically demanding phosphinimines R3PNH [R=i-Pr (1), t-Bu (2)] were examined. Reactions with B(C6F5)3 formed the adducts (R3PNH)B(C6F5)3 [R=i-Pr (3), t-Bu (4)] in high yield. On the other hand, 2 reacts with HB(OBu)2, evolving H2 to give t-Bu3PNB(OBu)2 (5). The reaction of 2 equiv of 2 with BH3.SMe2 affords the species (t-Bu3PN)2BH (6). In contrast, the reaction of n-Bu(t-Bu)2PNH with BH3.SMe2 results in the formation of the robust adduct n-Bu(t-Bu)2PNH.BH3 (8). An alternative route to borane-phosphinimide complexes involves Me3SiCl elimination, as exemplified by the reaction of BCl2Ph with n-Bu3PNSiMe3, which gives the product n-Bu3PNBCl(Ph) (9). The corresponding reactions of the parent phosphinimines 1 and 2 with AlH3.NMe2Et give the dimers [(mu-i-Pr3PN)AlH2]2 (10) and [(mu-t-Bu3PN)AlH2]2 (11). Species 11 reacts further with Me3SiO3SCF3 to provide [(mu-t-Bu3PN)AlH(OSO2CF3)]2 (12). The reaction of the lithium salt [t-Bu3PNLi]4 (13) with BCl3 proceeds smoothly to give t-Bu3PNBCl2 (14), which is readily alkylated to give t-Bu3PNBMe2 (15). Subsequent reaction of 15 with B(C6F5)3 results in methyl abstraction and the formation of [(mu-t-Bu3PN)BMe]2[MeB(C6F5)3]2 (16). The reaction of 13 in a 2:1 ratio with BCl3 gives the salt [(t-Bu3PN)2B]Cl (17). This species can be methylated to give (t-Bu3PN)2BMe (18), which undergoes subsequent reaction with [Ph3C][X] (X=[B(C6F5)4], [PF6]) to form the related salts [(t-Bu3PN)2B][B(C6F5)4] (19) and [(t-Bu3PN)2B][PF6] (20), respectively. Analogous reactions with [Ph3C][BF4] afforded [t-Bu3PNBF2]2 (21). Compounds 3, 4, 6, 8, 11, 12, 17, 19, and 21 were characterized by X-ray crystallography.

Use of step activity monitoring for continuous physical activity assessment in boys with Duchenne muscular dystrophy.

OBJECTIVES: To evaluate the StepWatch Activity Monitor (SAM) as a quantitative measure of community ambulation, to investigate activity patterns and heart rate of ambulatory boys with Duchenne muscular dystrophy (DMD), and to correlate the step activity with measures of body composition and strength. DESIGN: Case-control study. SETTING: General community and laboratory. PARTICIPANTS: Sixteen ambulatory boys with DMD and 20 male controls (age range, 5-13 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Laboratory determinations of body composition, knee extension strength, and minute-by-minute step rate and heart rate during 3 days of community activity. RESULTS: During the 3 days of activity, DMD subjects, when compared with controls, (1) had significantly more inactive minutes (1096+/-90 min/d vs 1028+/-85 min/d), (2) took significantly fewer steps and spent fewer minutes at moderate (66+/-31 min/d vs 94+/-30 min/d) and high step rates (43+/-30 min/d vs 72+/-38 min/d), (3) had higher resting heart rate (110+/-12 beats/min vs 94+/-7 beats/min) and lower increase in heart rate with increased step rate, and (4) had lower maximum heart rates (164+/-24 beats/min vs 208+/-16 beats/min). Percentage of body fat and knee extension strength correlated with total step activity in the DMD group but not in the control group. CONCLUSIONS: Step-rate monitoring with the SAM provides useful outcome measures with which to evaluate the activity of ambulatory boys with DMD. Their heart rate did not increase with activity to the same degree as observed in the control group.

Utility of a step activity monitor for the measurement of daily ambulatory activity in children.

OBJECTIVES: To evaluate the reliability and validity of the StepWatch Activity Monitor (SAM) as a reliable and valid measurement tool for assessing ambulatory activity in able-bodied children and to assess the ambulatory activity of able-bodied children. DESIGN: Descriptive study. SETTING: General community. PARTICIPANTS: Ninety-seven able-bodied children, aged 6 to 20 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Anthropometric parameters, calibration of a step activity monitor to ensure accuracy, and 3 days of simultaneous heart rate and step activity monitoring. RESULTS: The SAM had an accuracy of 99.87% compared with the observer-counted steps and was shown to be valid and reliable when compared with heart rate monitoring. The subjects in all age groups (6-10 y, 11-15 y, 16-20 y) spent most of their active time at low step rate but took the fewest steps at this rate. Although the least amount of time was spent at high step rate, it accounted for the most steps. The 6- to 10-year-old group took more total steps per day than any of the other groups. Boys spent significantly more time at high step rate than girls in all age groups (mean for boys, 66+/-4 min/d; girls, 47+/-4 min/d). CONCLUSIONS: The SAM is an accurate, valid, and useful tool for measuring continuous, time-based step activity during real-world community activity for children and adolescents.

Dissociation of 2,4-bis(2,4,6-tri-tert-butylphenyl)-cyclo-1,3-dipnicta-2,4-diazanes (pnict = P, As, Sb) imposed by substituent steric strain: a cyclobutane/olefin analogy.

Three 2,4-bis(Mes)-cyclo-1,3-dipnicta-2,4-diazanes, 2PnX, have been synthesized as 1,3-dichloro- (Pn = As; X = Cl) or 1,3-bis(triflato)- (Pn = P, Sb; X = OTf) derivatives (Mes = 2,4,6-tri-tert-butylphenyl; OTf = triflato = trifluoromethanesulfonoxy). The compounds have been structurally characterized as cyclodimers, but spectroscopic characterization of melts and solutions indicates facile dissociation of the diphosphadiazane 2POTf derivative to give the corresponding iminophosphine 1POTf and of the diarsadiazane 2AsCl derivative to give the corresponding iminoarsine 1AsCl. 1,3-Bis(triflato)-2,4-bis(Mes)-cyclo-1,3-distiba-2,4-diazane (2SbOTf) does not dissociate in the melt or in solution. The presence of the sterically bulky Mes substituent does not preclude association of N-Pn olefin analogues to give single bonded cyclobutane analogues. The facile dissociation of 2POTf and isolation of 1POTf implicates a relatively high degree of substituent steric strain in the dimer. In comparison, dissociation of 2AsCl is only apparent in the melt and in solution, likely the result of the lower substituent strain in the larger N(2)As(2) framework. The largest N(2)Pn(2) framework in 2SbOTf provides sufficient space for the Mes substituents, and the monomer is not observed under the conditions examined.

Transformations between monomeric, dimeric, and trimeric phosphazanes: oligomerizing NP analogues of olefins.

Isolation and characterization of a crystal mixture of iminophosphine 1 and diphosphazane 2 (R = Mes*, X = OTf) is enabled by the steric interactions between bulky substituents implicating monomer/dimer 1/2 equilibria and the conclusion is supported by the observation of a ring-expansion reaction to give a triphosphazane 3 (R = Dipp, X = Cl).