Tendinopathy—from basic science to treatment

Chronic tendon pathology (tendinopathy), although common, is difficult to treat. Tendons possess a highly organized fibrillar matrix, consisting of type I collagen and various 'minor' collagens, proteoglycans and glycoproteins. The tendon matrix is maintained by the resident tenocytes, and there is evidence of a continuous process of matrix remodeling, although the rate of turnover varies at different sites. A change in remodeling activity is associated with the onset of tendinopathy. Major molecular changes include increased expression of type III collagen, fibronectin, tenascin C, aggrecan and biglycan. These changes are consistent with repair, but they might also be an adaptive response to changes in mechanical loading. Repeated minor strain is thought to be the major precipitating factor in tendinopathy, although further work is required to determine whether it is mechanical overstimulation or understimulation that leads to the change in tenocyte activity. Metalloproteinase enzymes have an important role in the tendon matrix, being responsible for the degradation of collagen and proteoglycan in both healthy patients and those with disease. Metalloproteinases that show increased expression in painful tendinopathy include ADAM (a disintegrin and metalloproteinase)-12 and MMP (matrix metalloproteinase)-23. The role of these enzymes in tendon pathology is unknown, and further work is required to identify novel and specific molecular targets for therapy

Overrated gaps: Inter-speaker gaps provide limited information about the timing of turns in conversation

Corpus analyses have shown that turn-taking in conversation is much faster than laboratory studies of speech planning would predict. To explain fast turn-taking, Levinson and Torreira (2015) proposed that speakers are highly proactive: They begin to plan a response to their interlocutor's turn as soon as they have understood its gist, and launch this planned response when the turn-end is imminent. Thus, fast turn-taking is possible because speakers use the time while their partner is talking to plan their own utterance. In the present study, we asked how much time upcoming speakers actually have to plan their utterances. Following earlier psycholinguistic work, we used transcripts of spoken conversations in Dutch, German, and English. These transcripts consisted of segments, which are continuous stretches of speech by one speaker. In the psycholinguistic and phonetic literature, such segments have often been used as proxies for turns. We found that in all three corpora, large proportions of the segments comprised of only one or two words, which on our estimate does not give the next speaker enough time to fully plan a response. Further analyses showed that speakers indeed often did not respond to the immediately preceding segment of their partner, but continued an earlier segment of their own. More generally, our findings suggest that speech segments derived from transcribed corpora do not necessarily correspond to turns, and the gaps between speech segments therefore only provide limited information about the planning and timing of turns

Gene expression and matrix turnover in overused and damaged tendons

Chronic, painful conditions affecting tendons, frequently known as tendinopathy, are very common types of sporting injury. The tendon extracellular matrix is substantially altered in tendinopathy, and these changes are thought to precede and underlie the clinical condition. The tendon cell response to repeated minor injuries or “overuse” is thought to be a major factor in the development of tendinopathy. Changes in matrix turnover may also be effected by the cellular response to physical load, altering the balance of matrix turnover and changing the structure and composition of the tendon. Matrix turnover is relatively high in tendons exposed to high mechanical demands, such as the supraspinatus and Achilles, and this is thought to represent either a repair or tissue maintenance function. Metalloproteinases are a large family of enzymes capable of degrading all of the tendon matrix components, and these are thought to play a major role in the degradation of matrix during development, adaptation and repair. It is proposed that some metalloproteinase enzymes are required for the health of the tendon, and others may be damaging, leading to degeneration of the tissue. Further research is required to investigate how these enzyme activities are regulated in tendon and altered in tendinopathy. A profile of all the metalloproteinases expressed and active in healthy and degenerate tendon is required and may lead to the development of new drug therapies for these common and debilitating sports injuries

“It was touching”: Experiences and views of students in the June 3 flood and fire disaster relief response volunteerism in Accra, Ghana

Evidence from Africa on the motivations and experiences of student volunteers in community disaster relief response programs are rare. This study explores the experiences and views of the students who volunteered at the emergency mental health relief response site after the June 3, 2015, flood and fire disaster in Accra, and the implications for future professional response work in Ghana. Thematic analysis of 15 qualitative in-depth interviews showed that, overall, the student volunteers were both self-oriented and other-oriented. The students viewed work at the emergency response site as a touching experience and a call of duty. The response work provided the students with practical pathways to linking their clinical and community learning experiences. This study recommends that, rather than an ad hoc response team, the Ghana Psychological Association should consider setting up a standing disaster relief response network to provide mental health relief and recovery response in community emergency situations in Ghana

Volume 1, Number 1

Inside this issue: - The Hospitalers by Cyril B. Courville, Major, Medical Reserve Corps- Next Unit Meeting- Book review- Schedule of Coming Meetings, 47th General Hospital- Sergeant Sam Spoofer Says --- Personal 47th General Hospital-- Administrative-- Medical Service-- Surgical Service-- Dental Service-- Eye, Ear, Nose and Throat Service-- Laboratory- Lance and Basin- The Medical Cadet Corpshttps://scholarsrepository.llu.edu/hospitalers/1000/thumbnail.jp

Military Courtesies

- A Demonstration Conducted by the Staff of the 47th General Hospital, Lieut. Col. Newton Evans, Commanding-- (Opening Ceremony)-- A. Courtesies on the Drill Field-- B. Courtesies on the Athletic Field -- C. Courtesies Indoors-- D. Courtesies at an Army Post-- (Closing Ceremony)https://scholarsrepository.llu.edu/hospitalers/1015/thumbnail.jp

Volume 2, Number 4

Inside this issue: - Professional Service in a General Hospital, Cyril B. Courville, Major, Med-Res.- Exercise-- General Situation-- First Special Situation-- Requirement 1-- Second Special Situation-- Requirement 2-- Third Special Situation-- Requirement 3- Special Lesson No. 4 (1938-39 Series) (organization chart)- Solution- Special Text No. 4 (1938-39 Series)- The Principle of Reciprocal Function Between the Medical and Surgical Services of a General Hospital-- Variations in the Professional Service in a General Hospital-- A plan for Readjustment of Beds and Personnel under Variable Situations-- Functional Classification of the Professional Services-- Shift of Personnel in Emergent Situations--- The Unit System--- Plan of Function of the Unit System- Summary- Fixes vs. Non-fixed Personnel (organization chart)https://scholarsrepository.llu.edu/hospitalers/1008/thumbnail.jp

Volume 3, Number 1

Inside this issue: - The Peace-time Training Program of a General Hospital-- First Objective-- Second Objective-- Third Objective-- Fourth Objective-- Fifth Objective-- Training Program Methods and Dates-- Sixth Objective-- Seventh Objectivehttps://scholarsrepository.llu.edu/hospitalers/1009/thumbnail.jp

Volume 2, Number 1

Inside this issue: - Organization of a General Hospital, Cyril B. Courville, Major, Med.-Res.- Exercise-- General Situation-- First Special Situation-- Requirement-- Second Special Situation-- Requirement- Special Tex No. 1 (1938-39 Series)- Table 638W.--General Hospital (Normal Capacity: 1,000 Patients)- Remarks- Solutionhttps://scholarsrepository.llu.edu/hospitalers/1005/thumbnail.jp