Browsing by Person "Rush, Robert"

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A multi-disciplinary framework and rapid assessment tool for developmental co-ordination disorder services.
(2009-08) Forsyth, Kirsty; Maciver, Donald; Howden, Stella; Owen, Christine; Shepherd, C.; Rush, Robert
A Rasch analysis of the model of human occupation screening tool single observation form (MOHOST-SOF) in mental health
(SAGE, 2016-01) Maciver, Donald; Morley, M.; Forsyth, Kirsty; Bertram, N.; Edwards, T.; Heasman, D.; Rennison, J.; Rush, Robert; Willis, Suzie
Introduction This study examined the psychometric properties of the model of human occupation screening tool single observation form. Method Clinical records were extracted pre- and post-treatment for 152 mental health service users. Data were model of human occupation screening tool single observation form scores and demographics. We investigated the form using Rasch analysis; we also present an analysis of change over time. Results We identified four misfitting items and evidence of instability with respect to change over time. After anchoring to adjust for unstable estimates, it was possible to measure client change, and there were significant differences in scores pre-post treatment indicating client improvement in ability. Conclusion The study provides initial psychometric assessment of this version of the model of human occupation screening tool.
Acquisition of Maternal Education and its Relation to Single Word Reading in Middle Childhood: An Analysis of the Millennium Cohort Study
(Wayne State University (WSU) Press, 2017-11) King, T.; McKean, C.; Rush, Robert; Westrupp, E.; Mensah, F.; Law, James
Maternal education captured at a single time point is commonly employed as a predictor of a child's cognitive development. In this paper we ask what bearing the acquisition of additional qualifications has upon reading performance in middle childhood. This was a secondary analysis of the UK's Millennium Cohort Study, a birth cohort of 18,000 children born in 2000. Our outcome variable was Single Word Reading from the British Abilities Scales at 7 years. Predictors included maternal age and education, relative poverty and parity. Increasing maternal education over time was associated with improved child outcomes with a 2 month developmental advantage for children whose mothers had increased education over those whose mothers had not. Parity was important but conditional on this, there was no evidence of child attainment reducing for the children of older mothers. A time-varying education level model is consistent with an input quality mechanism for language development.
Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial)
(2015-07-22) Greenwood, Sharlene A.; Koufaki, Pelagia; Mercer, Tom; Rush, Robert; O'Connor, Ellen; Tuffnell, Rachel; Lindup, Herolin; Haggis, Lynda; Dew, Tracy; Abdulnassir, Lyndsey; Nugent, Eilish; Goldsmith, David; Macdougall, Iain C.
Background: Cardiovascular disease remains the leading cause of death in kidney transplant recipients. This pilot study examined the potential effect of aerobic training or resistance training on vascular health and indexes of cardiovascular risk in kidney transplant recipients. Study Design: Single-blind, randomized, controlled, parallel trial. Setting & Participants: 60 participants (mean age, 54 years; 34 men) were randomly assigned to aerobic training (n = 20), resistance training (n = 20), or usual care (n = 20). Participants were included if they had a kidney transplant within 12 months prior to baseline assessment. Patients were excluded if they had unstable medical conditions or had recently started regular exercise. Intervention: Aerobic training and resistance training were delivered 3 days per week for a 12-week period. The usual-care group received standard care. Outcomes & Measurements: Pulse wave velocity, peak oxygen uptake (Vo 2peak), sit-to-stand 60, isometric quadriceps force, and inflammatory biomarkers were assessed at 0 and 12 weeks. Results: The anticipated 60 participants were recruited within 12 months. 46 participants completed the study (aerobic training, n=13; resistance training, n=13; and usual care, n=20), resulting in a 23% attrition rate. Analyses of covariance, adjusted for baseline values, age, and dialysis vintage pretransplantation, revealed significant mean differences between aerobic training and usual care in pulse wave velocity of-2.20.4 (95% CI,-3.1 to-1.3) m/s (P <0.001) and between resistance training and usual care of-2.60.4 (95% CI,-3.4 to-1.7) m/s (P <0.001) at 12 weeks. Secondary analyses indicated significant improvements in Vo 2peak in the aerobic training group and in Vo 2peak, sit-to-stand 60, and isometric muscle force in the resistance training group compared with usual care at 12 weeks. There were no reported adverse events, cardiovascular events, or hospitalizations as a result of the intervention. Limitations: Pilot study, small sample size, no measure of endothelial function. Conclusions: Both aerobic training and resistance training interventions appear to be feasible and clinically beneficial in this patient population. 2015 National Kidney Foundation, Inc.
Alcohol purchasing by ill heavy drinkers; cheap alcohol is no single commodity
(2015-09-26) Gill, Jan; Chick, J.; Black, H.; Rees, C.; O'May, Fiona; Rush, Robert; McPake, Barbara
Objectives: Potential strategies to address alcohol misuse remain contentious. We aim to characterise the drink purchases of one population group: heavy drinkers in contact with Scottish health services. We contrast our findings with national sales data and explore the impact of socio-economic status on purchasing behaviour. Study design: Cross-sectional study comparing alcohol purchasing and consumption by heavy drinkers in Edinburgh and Glasgow during 2012. Methods: 639 patients with serious health problems linked to alcohol (recruited within NHS hospital clinics (in- and out-patient settings) 345 in Glasgow, 294 in Edinburgh) responded to a questionnaire documenting demographic data and last week's or a 'typical' weekly consumption (type, brand, volume, price, place of purchase). Scottish Index of Multiple Deprivation quintile was derived as proxy of sociodemographic status. Results: Median consumption was 184.8 (IQR = 162.2) UK units/week paying a mean of 39.7 pence per alcohol unit (0.397). Off-sales accounted for 95% of purchases with 85% of those <50 pence (0.5 UK) per alcohol unit. Corresponding figures for the Scottish population are 69% and 60%. The most popular low-priced drinks were white cider, beer and vodka with the most common off-sales outlet being the corner shop, despite supermarkets offering cheaper options. Consumption levels of the cheapest drink (white cider) were similar across all quintiles apart from the least deprived. Conclusions: Heavy drinkers from all quintiles purchase the majority of their drinks from off-sale settings seeking the cheapest drinks, often favouring local suppliers. While beer was popular, recent legislation impacting on the sale of multibuys may prevent the heaviest drinkers benefiting from the lower beer prices available in supermarkets. Non-etheless, drinkers were able to offset higher unit prices with cheaper drink types and maintain high levels of consumption. Whilst price is key, heavy drinkers are influenced by other factors and adapt their purchasing as necessary. 2015 The Authors.
An investigation into the minimum accelerometry wear time for reliable estimates of habitual physical activity and definition of a standard measurement day in pre-school children.
(IOP Science, 2014-11) Hislop, Jane; Law, James; Rush, Robert; Grainger, Andrew; Bulley, Catherine; Reilly, John J.; Mercer, Tom
The purpose of this study was to determine the number of hours and days of accelerometry data necessary to provide a reliable estimate of habitual physical activity in pre-school children. The impact of a weekend day on reliability estimates was also determined and standard measurement days were defined for weekend and weekdays. Accelerometry data were collected from 112 children (60 males, 52 females, mean (SD) 3.7 (0.7)yr) over 7 d. The Spearman-Brown Prophecy formula (S-B prophecy formula) was used to predict the number of days and hours of data required to achieve an intraclass correlation coefficient (ICC) of 0.7. The impact of including a weekend day was evaluated by comparing the reliability coefficient (r) for any 4 d of data with data for 4 d including one weekend day. Our observations indicate that 3 d of accelerometry monitoring, regardless of whether it includes a weekend day, for at least 7 h d-1 offers sufficient reliability to characterise total physical activity and sedentary behaviour of pre-school children. These findings offer an approach that addresses the underlying tension in epidemiologic surveillance studies between the need to maintain acceptable measurement rigour and retention of a representatively meaningful sample size.
Association of proximal elements of social disadvantage with children's language development at 2 years: An analysis of data from the Children in Focus (CiF) sample from the ALSPAC birth cohort
(Wiley, 2018-11-27) Law, James; Clegg, Judy; Rush, Robert; Roulstone, Sue; Peters, Tim J.
Background: An association between social disadvantage and early language development is commonly reported in the literature, but less attention has been paid to the way that different aspects of social disadvantage affect both expressive and receptive language in the first 2 years of life. Aims: To examine the contributions of gender, parental report of early language skills and proximal social variables (the amount of stimulation in the home, the resources available to the child and the attitudes/emotional status of the primary carer and the support available to him/her) controlling for distal social variables (family income and maternal education) to children's expressive and receptive language development at 2 years in a community ascertained population cohort. Methods & Procedures: Data from 1314 children in the Children in Focus (CiF) sample from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analyzed. Multivariable regression models identified the contribution of proximal (what parents do with their children) measures of social disadvantage adjusting for more distal (e.g., family income and material wealth) measures as well as early language development at 15 months to the development of verbal comprehension, expressive vocabulary and expressive grammar (word combinations) at 2 years of age. Outcome & Results: In the final multivariable models gender, earlier language and proximal social factors, co‐varying for distal factors predicted 36% of the variance for expressive vocabulary, 22% for receptive language and 27% for word combinations at 2 years. Language development at 15 months remained a significant predictor of outcomes at 24 months. Environmental factors were associated with both expressive scales but the picture was rather more mixed for receptive language suggesting that there may be different mechanisms underlying the different processes. Conclusions & Implications: This study supports the argument that social advantage makes a strong contribution to children's language development in the early years. The results suggest that what parents/carers do with their children is critical even when structural aspects of social disadvantage such as family income and housing have been taken into consideration although this relationship varies for different aspects of language. This has the potential to inform the targeting of public health interventions focusing on early language and pre‐literacy skills on the one hand and home learning environments on the other and, potentially, the two in combination.
Attachment as a partial mediator of the relationship between emotional abuse and schizotypy
(Elsevier, 2015-12-30) Goodall, Karen; Rush, Robert; Grunwald, Lisa; Darling, Stephen; Tiliopoulos, Niko
Developmental theories highlight the salience of attachment theory in explaining vulnerability towards psychosis. At the same time there is increasing recognition that psychosis is associated with childhood trauma variables. This study explored the interaction between attachment and several trauma variables in relation to schizotypy levels in a non-clinical sample. 283 non-clinical participants completed online measures of schizotypy, attachment, childhood abuse and neglect. When five types of abuse/neglect were entered into a linear regression analysis emotional abuse was the sole independent predictor of schizotypy. Age, attachment anxiety and avoidance were independent predictors after the effects of emotional abuse were controlled for. The overall model was significant, explaining 34% of the variation in schizotypy. Moderation analysis indicated that the effect of emotional abuse was not conditional upon attachment. Parallel mediation analysis indicated small but significant indirect effects of emotional abuse on schizotypy through attachment avoidance (13%) and attachment anxiety (8%). We conclude that emotional abuse contributes to vulnerability towards psychosis both directly and indirectly through attachment insecurity.
Auditory-verbal therapy for promoting spoken language development in children with permanent hearing impairments
(The Cochrane Collaboration, 2014-03) Brennan-Jones, Christopher G.; White, Joanna D.; Rush, Robert; Law, James
Background Congenital or early-acquired hearing impairment poses a major barrier to the development of spoken language and communication. Early detection and effective (re)habilitative interventions are essential for parents and families who wish their children to achieve age-appropriate spoken language. Auditory-verbal therapy (AVT) is a (re)habilitative approach aimed at children with hearing impairments. AVT comprises intensive early intervention therapy sessions with a focus on audition, technological management and involvement of the child's caregivers in therapy sessions; it is typically the only therapy approach used to specifically promote avoidance or exclusion of non-auditory facial communication. The primary goal of AVT is to achieve age-appropriate spoken language and for this to be used as the primary or sole method of communication. AVT programmes are expanding throughout the world; however, little evidence can be found on the effectiveness of the intervention. Objectives To assess the effectiveness of auditory-verbal therapy (AVT) in developing receptive and expressive spoken language in children who are hearing impaired. Search methods CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, speechBITE and eight other databases were searched in March 2013. We also searched two trials registers and three theses repositories, checked reference lists and contacted study authors to identify additional studies. Selection criteria The review considered prospective randomised controlled trials (RCTs) and quasi-randomised studies of children (birth to 18 years) with a significant (≥ 40 dBHL) permanent (congenital or early-acquired) hearing impairment, undergoing a programme of auditory-verbal therapy, administered by a certified auditory-verbal therapist for a period of at least six months. Comparison groups considered for inclusion were waiting list and treatment as usual controls. Data collection and analysis Two review authors independently assessed titles and abstracts identified from the searches and obtained full-text versions of all potentially relevant articles. Articles were independently assessed by two review authors for design and risk of bias. In addition to outcome data, a range of variables related to participant groups and outcomes were documented. Main results Of 2233 titles and abstracts searched, only 13 abstracts appeared to meet inclusion criteria. All 13 full-text articles were excluded following independent evaluation by two review authors (CGBJ and JW), as they did not meet the inclusion criteria related to the research design. Thus, no studies are included in this review. Authors' conclusions This review confirms the lack of well-controlled studies addressing the use of AVT as an intervention for promoting spoken language development in children with permanent hearing impairments. Whilst lack of evidence does not necessarily imply lack of effect, it is at present not possible for conclusions to be drawn as to the effectiveness of this intervention in treating children with permanent hearing impairments.
Changes in Substance Use and Risk Behaviours One Year after Treatment. Outcomes associated with a Quasi-Residential Rehabilitation Service for Alcohol and Drug Users in Edinburgh
(Taylor & Francis, 2017-06-23) Rome, A.; McCartney, D.; Best, D.; Rush, Robert
Despite limited evidence base, rehabilitation services are associated with positive outcomes in U.K. research (Best et al., _2010_ Best, D., Rome, A., Hanning, K., White, W., Gossop, M., Taylor, A., & Perkins, A. (2010). Research for recovery: A review of the drugs evidence base. Edinburgh, Scotland: Scottish Government. ). The authors investigated outcomes associated following a 12-week abstinence-based treatment program. Data were collected from 145 patients using a European Version of the Addiction Severity Index (ASI-X) at intake, 6 months, and 1 year after completion. Individuals showed significantly better ASI-X scores after participating in program compared to their scores prior to the intervention. Those who completed the program had significantly better outcomes in medical and psychiatric domains at 12-month follow-up than those who dropped out before completion. Attending this abstinence-based program was associated with positive changes to physical health and social wellbeing, which were sustained 12 months after completion.
Childhood language skills and adult literacy: A 29-year follow-up study
(American Academy of Pediatrics, 2010-03-01) Schoon, Ingrid; Parsons, Samantha; Rush, Robert; Law, James
OBJECTIVES: Our aim was to assess the longitudinal trajectory of childhood receptive language skills and early influences on the course of language development. METHODS: Drawing on data collected for a nationally representative British birth cohort, the 1970 British Cohort Study, we examined the relationship between directly assessed early receptive language ability, family background, housing conditions, early literacy environment, and adult literacy skills. A sample of 11 349 cohort members who completed the English Picture Vocabulary Test at 5 years of age were studied again at 34 years of age, when they completed a direct assessment of their basic literacy skills. We contrasted experiences of individuals with language problems at age 5 against the experiences of those with normal language skills at that age, assessing the role of socioeconomic family background and early literacy environment in influencing the longitudinal course of developmental language problems. Statistical comparisons of rates with 2 tests at P values of .001, .01, and .05 were made, as well as multivariate logistic regressions. RESULTS: Cohort members with receptive language problems at age 5 had a relatively disadvantaged home life in childhood, both in terms of socioeconomic resources and the education level of their parents, but also regarding their exposure to a stimulating early literacy environment. Although there is significant risk for poor adult literacy among children with early language problems, the majority of these children develop competent functional literacy levels by the age of 34. Factors that reduce the risk for persistent language problems include the child being born into a working family, parental education beyond minimum school-leaving age, advantageous housing conditions, and preschool attendance. CONCLUSION: Effective literacy-promoting interventions provided by pediatric primary care providers should target both children and parents. Copyright 2010 by the American Academy of Pediatrics.
Clinically relevant fatigue in cancer outpatients: the Edinburgh Cancer Centre symptom study
(2007-09-05) Storey, D. J.; Waters, Rachael A.; Hibberd, Carina J.; Rush, Robert; Cargill, A.; Wall, L. R.; Fallon, Marie T.; Strong, V.; Walker, J.; Sharpe, M.
Background: Fatigue is associated with cancer and its treatment but we know little about how many and which patients suffer fatigue of clinical severity. We aimed to determine the prevalence of clinically relevant fatigue (CRF) and its associations in outpatients with various cancer diagnoses. Patients and methods: A survey of outpatients with colorectal, breast, gynaecological, genitourinary, sarcoma, melanoma and miscellaneous tumours at a regional cancer centre. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) fatigue subscale and the Hospital Anxiety and Depression Scale (HADS). These self-report data were linked to demographic and clinical variables. Data were available on 2867 outpatients. Results: The prevalence of CRF (EORTC fatigue subscale ‡40) was 32% (95% confidence interval 31–34%). The variables independently associated with CRF were primary cancer site, having disease present, type of cancer treatment and emotional distress (total HADS score ‡15). Emotional distress had the strongest association with fatigue but half the cases of CRF were not distressed. Conclusion: CRF is common in cancer outpatients and is associated with type of disease and treatment, as well as with emotional distress. The association between CRF and emotional distress is strong but they are not equivalent conditions. Key words: associations, cancer, fatigue, predictors, prevalence, treatment
Community‐based participation of children with and without disabilities
(Wiley, 2019-11-25) Arakelyan, Stella; Maciver, Donald; Rush, Robert; O'Hare, Anne; Forsyth, Kirsty
AIM To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities.
Delirium in acute stroke: screening tools, incidence rates and predictors: a systematic review.
(springer verlag, 2012-08) Carin-Levy, Gail; Mead, Gillian; Nicol, Kath; Rush, Robert; van Wijck, Frederike
Delirium is a common complication in acute stroke yet there is uncertainty regarding how best to screen for and diagnose delirium after stroke. We sought to establish how delirium after stroke is identified, its incidence rates and factors predicting its development. We conducted a systematic review of studies investigating delirium in acute stroke. We searched The Cochrane Collaboration, MEDLINE, EMBASE, CINHAL, PsychINFO, Web of Science, British Nursing Index, PEDro and OT Seeker in October 2010. A total of 3,127 citations were screened, full text of 60 titles and abstracts were read, of which 20 studies published between 1984 and 2010 were included in this review. The methods most commonly used to identify delirium were generic assessment tools such as the Delirium Rating Scale (n = 5) or the Confusion Assessment Method (n = 2) or both (n = 2). The incidence of delirium in acute stroke ranged from 2.3-66%, with our meta-analysis random effects approach placing the rate at 26% (95% CI 19-33%). Of the 11 studies reporting risk factors for delirium, increased age, aphasia, neglect or dysphagia, visual disturbance and elevated cortisol levels were associated with the development of delirium in at least one study. The outcomes associated with the condition are increased morbidity and mortality. Delirium is found in around 26% of stroke patients. Difference in diagnostic and screening procedures could explain the wide variation in frequency of delirium. There are a number of factors that may predict the development of the condition.
Development of a prognostic model for stump healing in major lower limb amputation among the diabetic population
(MDPI, 2021-07-12) Ashraff, Suhel; Siddiqui, Muhammad; Carline, Tom; Rush, Robert; Santos, Derek; Raza, Zahid
Background: This study aimed to explore the effect of haematological markers as well as patient characteristics on stump healing in patients who underwent a lower limb amputation procedure. In addition, a practical model regarding factors that affected stump healing was developed. Methods: Patients who underwent a major lower limb amputation (above knee and below knee) at the Royal Infirmary of Edinburgh from the period of 2007 to 2010 were included in this study. A prognostic model utilizing backward stepwise logistical regression was developed to measure the probability of lower limb stump healing. The relationship between the dependent and independent variables was identified using univariate and multivariate logistic regression. Results: Three variables, namely serum sodium, serum creatinine and serum high density lipid cholesterol were identified which influenced stump healing. Patients with normal serum sodium were 75% more likely to have lower limb stump healing compared to that of patients with abnormal serum sodium (odds ratio [OR] 1.756; 95% confidence interval [CI] 1.048–2.942). Patients with normal serum creatinine were 66% more likely to have their stump healed (OR 1.664; 95% CI 0.94 to 2.946). The healing rate of patients with a normal level of serum high density lipid cholesterol was 75%, in contrast to patients with an aberrant level of serum high density lipids cholesterol (OR 1.753; 95% CI 1.061 to 2.895). The effectiveness of the retrospective stump-healing model was demonstrated by the area under the ROC curve (0.612), which was supported by the Hosmer and Lemeshow goodness-of-fit test (p = 0.879). Conclusions: Serum sodium, serum high density lipid cholesterol and serum creatinine have a strong correlation with lower limb stump healing. However, serum sodium and serum high density lipid cholesterol secondary to multiple co-morbidities in this cohort group could be altered secondary to disease pathology itself.
Development of prognostic model for fistula maturation in patients with advanced renal failure
(BioMed Central, 2018-03-07) Siddiqui, Muhammad A.; Ashraff, Suhel; Santos, Derek; Rush, Robert; Carline, Tom; Raza, Zahid
Background: This study aimed to explore the role of patient's characteristic and haematological factors as predictive on the maturation of arteriovenous fistulae in patients who underwent vascular access surgery at the Royal Infirmary of Edinburgh. Methods: Retrospective data from 300 patients who had undergone fistula creation between February 2007 and October 2010 was examined. A predictive logistic regression model was developed using the backward stepwise procedure. Model performance, discrimination and calibration, was assessed using the receiver operating characteristics (ROC) curve and Hosmer and Lemeshow goodness of fit test. Results: Three variables were identified which independently influenced fistula maturation. Males were twice as likely to undergo fistula maturation, compared to that of females (odds ratio (OR) 0.514; 95% confidence interval (CI) 0.308-0.857), patients with no evidence of peripheral vascular disease (PVD) were three times more likely to mature their fistula (OR 3.140; 95% CI 1.596-6.177) and a pre-operative vein diameter > 2.5 mm resulted in a fivefold increase in fistula maturation compared to a vein size less than 2.5 mm (OR 4.532; 95% CI 2.063-9.958). The model for fistula maturation had fair discrimination as indicated by the area under the ROC curve (0.68; 95% CI 0.615-0. 738) but good calibration indicated by Hosmer and Lemeshow test (p = 0.79). Conclusion: Gender, PVD and vein size are independent predictors of arteriovenous fistula maturation. The clinical utility of these risk equation in the maturation of arteriovenous fistulae requires further validation in the newly treated patients.
Developmental Co-ordination disorder: supporting professionals to provide evidence based care.
(2009-03) Forsyth, Kirsty; Maciver, Donald; Howden, Stella; Owen, Christine; Shepherd, C.; Rush, Robert
Differences in assistive technology installed for people with dementia living at home who have wandering and safety risks
(BMC, 2021-10-30) Curnow, Eleanor; Rush, Robert; Górska, Sylwia; Forsyth, Kirsty
Background: Assistive Technology for people with dementia living at home is not meeting their care needs. Reasons for this may be due to limited understanding of variation in multiple characteristics of people with dementia including their safety and wandering risks, and how these affect their assistive technology requirements. This study therefore aimed to explore the possibility of grouping people with dementia according to data describing multiple person characteristics. Then to investigate the relationships between these groupings and installed Assistive Technology interventions. Methods: Partitioning Around Medoids cluster analysis was used to determine participant groupings based upon secondary data which described the person characteristics of 451 people with dementia with Assistive Technology needs. Relationships between installed Assistive Technology and participant groupings were then examined. Results: Two robust clustering solutions were identified within the person characteristics data. Relationships between the clustering solutions and installed Assistive Technology data indicate the utility of this method for exploring the impact of multiple characteristics on Assistive technology installations. Living situation and caregiver support influence installation of assistive technology more strongly than level of risk or cognitive impairment. People with dementia living alone received different AT from those living with others. Conclusions: Results suggest that caregiver support and the living situation of the person with dementia influence the type and frequency of installed Assistive Technology. Reasons for this include the needs of the caregiver themselves, the caregiver view of the participants’ needs, caregiver response to alerts, and the caregiver contribution to the assistive technology assessment and selection process. Selection processes should be refined to account for the needs and views of both caregivers and people with dementia. This will require additional assessor training, and the development of validated assessments for people with dementia who have additional impairments. Policies should support the development of services which provide a wider range of AT to facilitate interventions which are focused on the needs of the person with dementia.
Early home activities and oral language skills in middle childhood: A quantile analysis
(Wiley, 2017-02-23) Law, James; Rush, Robert; King, Tom; Westrupp, Elizabeth; Reilly, Sheena
Oral language development is a key outcome of elementary school, and it is important to identify factors that predict it most effectively. Commonly researchers use ordinary least squares regression with conclusions restricted to average performance conditional on relevant covariates. Quantile regression offers a more sophisticated alternative. Using data of 17,687 children from the United Kingdom's Millennium Cohort Study, we compared ordinary least squares and quantile models with language development (verbal similarities) at 11 years as the outcome. Gender had more of an effect at the top of the distribution, whereas poverty, early language, and reading to the child had a greater effect at the bottom. The picture for TV watching was more mixed. The results are discussed in terms of the provision of universal and targeted interventions.
Effect of Exercise Training on Estimated GFR, Vascular Health, and Cardiorespiratory Fitness in Patients With CKD: A Pilot Randomized Controlled Trial
(2014-09-15) Greenwood, Sharlene A.; Koufaki, Pelagia; Mercer, Tom; MacLaughlin, Helen L.; Rush, Robert; Lindup, Herolin; O'Connor, Ellen; Jones, Christopher; Hendry, Bruce M.; Macdougall, Iain C.; Cairns, Hugh S.
Background: Exercise capacity, which is predictive of all-cause mortality and cardiovascular disease risk, is reduced significantly in patients with non-dialysis-dependent chronic kidney disease. This pilot study examined the effect of moderate-intensity exercise training on kidney function and indexes of cardiovascular risk in patients with progressive chronic kidney disease stages 3 to4. Study Design: Single-blind, randomized, controlled, parallel trial. Setting & Participants: 20 patients (aged 18-80 years; 17 men) randomly assigned to rehabilitation (n=10) or usual care (n=10). Participants were included if they were 18 years or older and had evidence of rate of decline in creatinine-based estimated glomerular filtration rate (eGFRcr)≥2.9mL/min/1.73m2 per year for 12 months preintervention. Patients were excluded if they had unstable medical conditions or had recently started regular exercise. Intervention: The rehabilitation group received resistance and aerobic training (3 days per week) for a 12-month period. The usual care group received standard care. Outcomes: Kidney function assessed by comparing mean rate of change in eGFRcr (mL/min/1.73m2 per year) from a 12-month preintervention period against the 12-month intervention period. Pulse wave velocity (PWV), peak oxygen uptake (Vo 2peak), and waist circumference assessed at 0, 6, and 12 months. Measurements: eGFR assessed using creatinine, cystatin C (eGFRcys), and a combination of both values (eGFRcr-cys). Results: 18 participants (rehabilitation, 8; usual care, 10) completed the study. A significant mean difference in rate of change in eGFRcr (+7.8±3.0 [95% CI, 1.1-13.5] mL/min/1.73m2 per year; P =0.02) was observed between the rehabilitation and usual care groups, with the rehabilitation group demonstrating a slower decline. No significant between-group mean differences existed in absolute eGFRcr, eGFRcr-cys, or eGFRcys at 12 months of study intervention. Significant between-group mean differences existed in PWV (-2.30 [95% CI,-3.02 to-1.59] m/s), waist circumference (-7.1±12.8 [95% CI,-12.4 to-3.2] cm), and Vo 2peak (5.7 [95% CI, 1.34-10.10] mL/kg/min). Change in eGFRcr was correlated inversely with PWV (r =-0.5; P =0.04) at 12 months. Limitations: Small sample size, inconsistency between primary and secondary measures of kidney function. Conclusions: The effect of a 1-year exercise intervention on progression of kidney disease is inconclusive. A larger study with longer follow-up may be necessary.