The prevalence and risks of injury for masters athletes : current findings

textRegular physical activity and exercise are important clinical tools that can be used to improve our health. This is especially true due to the prolonged lifespan of the average adult and the declines in physical function that are attributed to advancing age. Those functional detriments can be controlled or reversed via regular exercise, and as a result, the growth of competitive sports targeted to the elderly is on the rise. These events have created generations of Masters athletes. However, continued growth of and successful participation in these competitions may be limited by an unfounded belief that an increased risk of sports injury occurs as we age. This notion is not supported by the available scientific literature. The preponderance of epidemiological evidence demonstrates no age-associated increase in injury for Masters athletes. This remains true even when the research has focused on specific injury types such as connective tissue. To unequivocally answer question of whether elderly athletes are at a high risk of injury, future research will need to focus on providing more rigorous controls over activity levels and training status as both of these variables are likely confounding the current conclusions that can be drawn when comparing young and old athletes. It will also be beneficial to specifically study the association between altered muscle function, age and injury. This association has not been addressed within the Masters athlete population, but could provide potent insight into the aging process of habitual exercisers.Kinesiology and Health Educatio

The close limit from a null point of view: the advanced solution

We present a characteristic algorithm for computing the perturbation of a Schwarzschild spacetime by means of solving the Teukolsky equation. We implement the algorithm as a characteristic evolution code and apply it to compute the advanced solution to a black hole collision in the close approximation. The code successfully tracks the initial burst and quasinormal decay of a black hole perturbation through 10 orders of magnitude and tracks the final power law decay through an additional 6 orders of magnitude. Determination of the advanced solution, in which ingoing radiation is absorbed by the black hole but no outgoing radiation is emitted, is the first stage of a two stage approach to determining the retarded solution, which provides the close approximation waveform with the physically appropriate boundary condition of no ingoing radiation.Comment: Revised version, published in Phys. Rev. D, 34 pages, 13 figures, RevTe

Agenda-setting revisited: When and how do primary-care physicians solicit patients’ additional concerns?

Objective: Soliciting patients’ complete agendas of concerns (aka. ‘agenda setting’) can improve patients’ health outcomes and satisfaction, and physicians’ time management. We assess the distribution, content, and effectiveness of physicians’ post-chief-complaint, agenda-setting questions. Methods: We coded videotapes/transcripts of 407 primary-, acute-care visits between adults and 85 general-practice physicians operating in 46 community-based clinics in two states representing urban and rural care. Measures are the incidence of physicians’ questions, their linguistic format, position within visits, likelihood of being responded to, and the nature of such responses. Results: Physicians’ questions designed to solicit concerns additional to chief concerns occurred in only 32% of visits (p \u3c .001). Compared to questions whose communication format explicitly solicited ‘questions’ (e.g., “Do you have any questions?”), those that were formatted so as to allow for ‘concerns’ (e.g., “Any other concerns?”) were significantly more likely to generate some type of agenda item (Chi2 (1, N = 131) = 11.96, p = .001), and to do so more frequently when positioned ‘early’ vs. ‘late’ during visits (Chi2 (1, N = 73) = 4.99, p = .025). Conclusions: Agenda setting is comparatively infrequent. The communication format and position of physicians’ questions affects patients’ provision of additional concerns/questions. Practice implications: Physicians should increase use of optimized forms of agenda setting

The twilight of the Liberal Social Contract? On the Reception of Rawlsian Political Liberalism

This chapter discusses the Rawlsian project of public reason, or public justification-based 'political' liberalism, and its reception. After a brief philosophical rather than philological reconstruction of the project, the chapter revolves around a distinction between idealist and realist responses to it. Focusing on political liberalism’s critical reception illuminates an overarching question: was Rawls’s revival of a contractualist approach to liberal legitimacy a fruitful move for liberalism and/or the social contract tradition? The last section contains a largely negative answer to that question. Nonetheless the chapter's conclusion shows that the research programme of political liberalism provided and continues to provide illuminating insights into the limitations of liberal contractualism, especially under conditions of persistent and radical diversity. The programme is, however, less receptive to challenges to do with the relative decline of the power of modern states

Constitutivism

A brief explanation and overview of constitutivism

The hyporheic zone as an invertebrate refuge: a review of variability in space, time, taxa and behaviour

The hyporheic zone is a potential refuge that can promote persistence of benthic invertebrates during adverse conditions in surface streams. For decades, changes in invertebrate depth distribution have been investigated in relation to flood, low flow and drying events, but evidence for use of the hyporheic refuge remains equivocal. This review examines the evidence for the hyporheic zone’s refugial role during adverse hydrological conditions. Refuge potential is influenced by determinants in four categories. First, refuge use varies spatially in relation to physical habitat parameters, including sediment porosity and hydrologic exchange. Second, refuge use is temporally variable and reflects disturbance characteristics including rate of onset. Third, refuge use is taxon-specific, depending on a range of morphological, behavioural and physiological traits. Fourth, the behaviours governing refuge use vary, with both active migrations and passive habitat use playing important roles in community persistence. These four determinants interact to influence refuge use; for example, the physical habitat providing an adequate refuge will vary between taxa. Despite this variability, the hyporheic zone is an important component in the suite of refuges that facilitate community resilience to disturbance events. As such, its ecological integrity should be safeguarded through sensitive management and effective rehabilitation schemes

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes