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Background: Parkinson's Disease (PD) is a progressive neurological disorder that results in potentially debilitating mobility deficits. Recently, spinal cord stimulation (SCS) has been proposed as a novel therapy for PD gait disorders. The highest levels of evidence remain limited for SCS. Objectives: In this systematic review and narrative synthesis, the literature was searched using combinations of key phrases indicating spinal cord stimulation and PD. Methods: We included pre‐clinical studies and all published clinical trials, case reports, conference abstracts as well as protocols for ongoing clinical trials. Additionally, we included trials of SCS applied to atypical parkinsonism. Results: A total of 45 human studies and trials met the inclusion criteria. Based on the narrative synthesis, a number of knowledge gaps and future avenues of potential research were identified. This review demonstrated that evidence for SCS is currently not sufficient to recommend it as an evidence‐based therapy for PD related gait disorders. There remain challenges and significant barriers to widespread implementation, including issues regarding patient selection, effective outcome selection, stimulation location and mode, and in programming parameter optimization. Results of early randomized controlled trials are currently pending. SCS is prone to placebo, lessebo and nocebo as well as blinding effects which may impact interpretation of outcomes, particularly when studies are underpowered. Conclusion: Therapies such as SCS may build on current evidence and be shown to improve specific gait features in PD. Early negative trials should be interpreted with caution, as more evidence will be required to develop effective methodologies in order to drive clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: Respiratory abnormalities such as upper airway obstruction are common in Parkinson's disease (PD) and are an important cause of mortality and morbidity. We tested the effect of pedunculopontine region (PPNr) stimulation on respiratory maneuvers in human participants with PD, and separately recorded PPNr neural activity reflected in the local field potential (LFP) during these maneuvers. Methods: Nine patients with deep brain stimulation electrodes in PPNr, and seven in globus pallidus interna (GPi) were studied during trials of maximal inspiration followed by forced expiration with stimulation OFF and ON. Local field potentials (LFPs) were recorded in the unstimulated condition. Results: PEFR increased from 6.41 ± 0.63 L/sec in the OFF stimulation state to 7.5 L ± 0.65 L/sec in the ON stimulation state (z = −2.666, df = 8, P = 0.024). Percentage improvement in PEFR was strongly correlated with proximity of the stimulated electrode contact to the mesencephalic locomotor region in the rostral PPN (r = 0.814, n = 9, P = 0.008). Mean PPNr LFP power increased within the alpha band (7–11 Hz) during forced respiratory maneuvers (1.63 ± 0.16 μV2/Hz) compared to resting breathing (0.77 ± 0.16 μV2/Hz; z = −2.197, df = 6, P = 0.028). No changes in alpha activity or spirometric indices were seen with GPi recording or stimulation. Percentage improvement in PEFR was strongly positively correlated with increase in alpha power (r = 0.653, n = 14 (7 PPNr patients recorded bilaterally), P = 0.0096). Interpretation: PPNr stimulation in PD improves indices of upper airway function. Increased alpha‐band activity is seen within the PPNr during forced respiratory maneuvers. Our findings suggest a link between the PPNr and respiratory performance in PD. [ABSTRACT FROM AUTHOR]

Objective: To determine the efficacy of a breakfast promotion intervention based on Health Promoting Schools processes. Design: Schools were recruited and randomly allocated into intervention (seven schools) or control (six schools) groups. Intervention schools formed working groups, discussed their specific breakfast issues, and developed, implemented and evaluated their action plans. The students completed a survey on breakfast eating habits and knowledge at baseline (February-April 2002) and at follow up (November-December 2002). Subjects: 792 seventh grade students (11-12 years) (n = 341 for the control group; n =451 for the intervention group). The response rate for completion of the follow up survey was 95% for the intervention group and 96% for the control group. Setting: Thirteen schools, including 12 government and one independent school, with seven located in metropolitan, four in rural and two in remote areas of southern Queensland. Main outcome measures: Proportion of children reporting they usually skip breakfast one or more days per school week; Consumption of selected breakfast food items, including energy-dense, micronutrient-poor food or beverage choices; Selection of perceived 'healthy breakfast meals' from a list provided. Statistical analyses; Frequencies of responses and cross tabulations were calculated using SPSS version 11.0. Results: Breakfast skipping increased by a greater percentage in the control group compared to the intervention group (20.2% vs 4.5%). The proportion of children reporting that they ate at least one 'poor food choice' for breakfast on the day of the survey decreased from 16.4% to 14.8% for the intervention group, while this rate more than doubled (9.7% to 19.9%) for the control group. Conclusion or application: Use of the Health Promoting Schools approach to address the quality of breakfast consumption by upper primary school children is recommended as an effective methodology. [ABSTRACT FROM AUTHOR]

Objective: To describe the settings for, and foods eaten at, breakfast for a sample of Queensland school children. Design: A cross-sectional study using a 17-item. self-completed questionnaire, and recall of all foods and beverages consumed for breakfast on the day of the survey. Subjects: Eight hundred and thirty-two upper primary school students (11 to 12 years of age). Setting: Fourteen schools from urban and rural locations in southern Queensland. Main outcome measures: • Foods and beverages reported consumed for breakfast. • The percentage of children who reported consuming energy-dense, micronutrient-poor food or beverage choices. • Location of breakfast consumption. Persons preparing breakfast. • Foods purchased on the way to school. • Classification of foods purchased according to the Australian Guide to Healthy Eating food groups. Statistical analyses: Frequencies of responses and cross tabulations using SPSS version 11.0. Results: Useable responses were obtained from 828 (99.5%) students. The most common breakfast item reported was breakfast cereal (55%). A third of children reported consuming a breakfast containing items from three or more food groups from the Australian Guide to Healthy Eating, while 22% of children consumed energy-dense, micronutrient-poor foods or beverages. Food was reported to have been purchased on the way to school in the week prior to the survey by 20% of children. Conclusion: The quality of breakfast food choices needs to be addressed, especially the intake of energy-dense, micronutrient-poor food items and the frequency and types of foods purchased on the way to school. Strategies that include parents, children, the school and community settings are recommended. [ABSTRACT FROM AUTHOR]

Explains that the academic paper "Meat consumption among 18-month-old children participating in the Childhood Asthma Prevention Study" by K. Webb et al raise a number of considerations which are important in obtaining useful information from population dietary studies in Australia. Detailed methods of dietary data collection enable multiple uses; Assessment and reporting of food as well as nutrient intake; Respondent burden and response rate.