The Influence of Hip Strength and Core Endurance on Recurrent Patella Dislocations: A Pilot Study

BACKGROUND AND PURPOSE: Patellar instability can be a source of pain and functional disability. Aspects of patellar dislocations explored in the literature include demographics, radiographic findings, physical features, and quadriceps and hamstring strength. A lack of information exists on muscular strength as a predisposing factor for recurrent patellar dislocations. The aim of this study was to determine the influence of hip strength and core endurance on recurrent patellar dislocations. It was hypothesized that decreased hip strength and core endurance would be associated with this injury. METHODS: In this case control study, cases with recurrent patellar dislocation at a rehabilitation clinic were all offered the chance to participate. Healthy controls without any current knee injuries or previous surgeries were matched by sex and age. Participants provided anthropometric and demographic data and filled out the International Physical Activity Questionnaire, KOOS Knee Survey, Kujala Knee Pain Scale, and a patellofemoral instability form. Cases underwent a patellofemoral exam and joint testing protocol. Both groups completed the forward step down test, strength of hip external rotation and abduction using a dynamometer, and bilateral side plank endurance. Recordings of the forward step down test were reviewed by six researchers to determine inter-rater reliability. RESULTS: Side plank endurance and hip external rotation strength were significantly decreased in the cases compared to the controls. There was no statistical difference for hip abduction strength between the two groups. Moderate to good inter-rater reliability was found for the forward step down test. CONCLUSIONS: Weak hip external rotators and core endurance could lead to an increased risk for patellar dislocations. While hip abduction strength was not statistically significant between cases and controls, it was 4% less in the case group. The gluteus medius is active during side plank exercise and may contribute to significant results observed in core endurance testing. The forward step down test could be used to assess dynamic weakness in hip abductors and external rotators across providers based on reliability findings. This pilot study was the first to investigate hip strength and core endurance as a risk factor for recurrent patellar dislocations and further research is needed to confirm findings

Maternal Knowledge, Attitudes, and Practices Concerning Interpregnancy Interval

Introduction. Few studies have examined maternal intentions andpractices related to interpregnancy interval (IPI). IPI less than 18months has been linked to increased preterm birth and infant mortality.This manuscript reports on a cross-sectional survey of mothersconducted to understand maternal knowledge, attitudes, and practiceof IPI in Sedgwick County, Kansas. Methods. New and expectant mothers and mothers of neonatalinfant care unit (NICU) graduates (n = 125) were surveyed regardingthe issues surrounding IPI. Front desk staff handed out self-administeredsurveys, which were returned to a nurse upon completion.NICU participants were emailed a link to the survey hosted on SurveyMonkey®. Results. Fewer than 30% of mothers reported previously receivinginformation about IPI from any source. When asked about risks associatedwith IPI, women frequently (n = 58, 45%) identified increasedrisk for birth outcomes with no known association with short IPI.Findings regarding maternal attitudes surrounding optimal IPI weremixed with many mothers defining ideal IPI as less than 18 months(n = 52, 42%), while broadly reporting they believed that a woman’sbody needs time to heal between pregnancies. Respondents from theNICU sample generally reported shorter optimal IPI values than theother participants. When IPI was estimated from participants’ pastpregnancies, half of IPIs were less than 18 months. Mothers reportedthey favored healthcare providers as a source for IPI education. Faceto-face discussions or printed materials were the preferred modes ofeducation. Conclusions. Women were aware of the need for spacing betweenpregnancies, however, that knowledge was unassociated with pastbehavior. These findings should be taken into consideration whenformulating future interventions. Kans J Med 2018;11(4):86-90

Consequences of recreational hunting for biodiversity conservation and livelihoods

The widespread activity of recreational hunting is proposed as a means of conserving nature and supporting livelihoods. However, recreational hunting-especially trophy hunting-has come under increasing scrutiny based on ethical concerns and the arguments that it can threaten species and fail to contribute meaningfully to local livelihoods. We provide an overview of the peer-reviewed literature on recreational hunting of terrestrial birds and mammals between 1953 and 2020 (> 1,000 papers). The most-studied species are large mammals from North America, Europe, and Africa. While there is extensive research on species' ecology to inform sustainable hunting practices, there is comparably little research on the role of local perceptions and institutions in determining socioeconomic and conservation outcomes. Evidence is lacking to answer the pressing questions of where and how hunting contributes to just and sustainable conservation efforts. We outline an agenda to build this evidence base through research that recognizes diverse social-ecological contexts.Peer reviewe

Development of the cat-owner relationship scale (CORS)

Characteristics of the human-animal bond can be influenced by both owner-related and pet-related factors, which likely differ between species. Three studies adapted the Monash Dog-Owner Relationship Scale (MDORS) to permit assessment of human-cat interactions as perceived by the cat's owner. In Study 1293 female cat owners completed a modified version of the MDORS, where 'dog' was replaced with 'cat' for all items. Responses were compared with a matched sample of female dog owners. A partial least squares discriminant analysis revealed systematic differences between cat and dog owners in the Dog (Cat)-Owner Interaction subscale (MDORS subscale 1), but not for Perceived Emotional Closeness or Perceived Costs (Subscales 2 and 3). Study 2 involved analysis of free-text descriptions of cat-owner interactions provided by 61 female cat owners. Text mining identified key words which were used to create additional questions for a new Cat-Owner Interaction subscale. In Study 3, the resulting cat-owner relationship scale (CORS) was tested in a group of 570 cat owners. The main psychometric properties of the scale, including internal consistency and factor structure, were evaluated. We propose that this scale can be used to accurately assess owner perceptions of their relationship with their cat. A modified scale, combining items from the CORS and MDORS (a C/DORS), is also provided for when researchers would find it desirable to compare human-cat and human-dog interactions. (C) 2017 Elsevier B.V. All rights reserved

CO2 storage potential at Forties oilfield and the surrounding Paleocene sandstone aquifer accounting for leakage risk through abandoned wells

A numerical simulation study of CO2 injection into the Forties and Nelson oilfields to estimate their storage potential is presented in this paper. The estimation involves the consideration of key-performance indicator parameters that include: the pressure build-up for different rates and locations of injection, the regional mass fraction of CO2, the volumetric efficiency of the storage reservoirs, and the plume size. Various injection scenarios were compared in terms of these parameters, and the best scenario was identified for the capacity estimation. Potential leakage through the wellbores in the surrounding saline aquifer was also investigated

Revisiting cannabinoid receptor 2 expression and function in murine retina.

The cannabinoid receptor CB2 plays a significant role in the regulation of immune function whereas neuronal expression remains a subject of contention. Multiple studies have described CB2 in retina and a recent study showed that CB2 deletion altered retinal visual processing. We revisited CB2 expression using immunohistochemistry and a recently developed CB2-eGFP reporter mouse. We examined the consequence of acute vs. prolonged CB2 deactivation on the electroretinogram (ERG) responses. We also examined lipidomics in CB2 knockout mice and potential changes in microglia using Scholl analysis. Consistent with a published report, in CB2 receptor knockout mice see an increased ERG scotopic a-wave, as well as stronger responses in dark adapted cone-driven ON bipolar cells and, to a lesser extent cone-driven ON bipolar cells early in light adaptation. Significantly, however, acute block with CB2 antagonist, AM630, did not mimic the results observed in the CB2 knockout mice whereas chronic (7 days) block did. Immunohistochemical studies show no CB2 in retina under non-pathological conditions, even with published antibodies. Retinal CB2–eGFP reporter signal is minimal under baseline conditions but upregulated by intraocular injection of either LPS or carrageenan. CB2 knockout mice see modest declines in a broad spectrum of cannabinoid-related lipids. The numbers and morphology of microglia were unaltered. In summary minimal CB2 expression is seen in healthy retina. CB2 appears to be upregulated under pathological conditions. Previously reported functional consequences of CB2 deletion are an adaptive response to prolonged blockade of these receptors. CB2 therefore impacts retinal signaling but perhaps in an indirect, potentially extra-ocular fashion.post-print8285 K

Provision of palliative and end-of-life care in UK care homes during the COVID-19 pandemic: A mixed methods observational study with implications for policy

© 2023 Bradshaw, Ostler, Goodman, Batkovskyte, Ellis-Smith, Tunnard, Bone, Barclay, Vernon, Higginson, Evans and Sleeman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/Introduction: Little consideration has been given to how the provision of palliative and end-of-life care in care homes was affected by COVID-19. The aims of this study were to: (i) investigate the response of UK care homes in meeting the rapidly increasing need for palliative and end-of-life care during the COVID-19 pandemic and (ii) propose policy recommendations for strengthening the provision of palliative and end-of-life care within care homes. Materials and methods: A mixed methods observational study was conducted, which incorporated (i) an online cross-sectional survey of UK care homes and (ii) qualitative interviews with care home practitioners. Participants for the survey were recruited between April and September 2021. Survey participants indicating availability to participate in an interview were recruited using a purposive sampling approach between June and October 2021. Data were integrated through analytic triangulation in which we sought areas of convergence, divergence, and complementarity. Results: There were 107 responses to the survey and 27 interviews. We found that (i) relationship-centered care is crucial to high-quality palliative and end-of-life care within care homes, but this was disrupted during the pandemic. (ii) Care homes' ability to maintain high-quality relationship-centered care required key “pillars” being in place: integration with external healthcare systems, digital inclusion, and a supported workforce. Inequities within the care home sector meant that in some services these pillars were compromised, and relationship-centered care suffered. (iii) The provision of relationship-centered care was undermined by care home staff feeling that their efforts and expertise in delivering palliative and end-of-life care often went unrecognized/undervalued. Conclusion: Relationship-centered care is a key component of high-quality palliative and end-of-life care in care homes, but this was disrupted during the COVID-19 pandemic. We identify key policy priorities to equip care homes with the resources, capacity, and expertise needed to deliver palliative and end-of-life care: (i) integration within health and social care systems, (ii) digital inclusivity, (iii) workforce development, (iv) support for care home managers, and (v) addressing (dis)parities of esteem. These policy recommendations inform, extend, and align with policies and initiatives within the UK and internationally.Peer reviewe

Efficacy of Oral Metronidazole with Vaginal Clindamycin or Vaginal Probiotic for Bacterial Vaginosis: Randomised Placebo-Controlled Double-Blind Trial

BACKGROUND: To determine if oral metronidazole (MTZ-400 mg bid) with 2% vaginal clindamycin-cream (Clind) or a Lactobacillus acidophilus vaginal-probiotic containing oestriol (Prob) reduces 6-month bacterial vaginosis (BV) recurrence. METHODS: Double-blind placebo-controlled parallel-group single-site study with balanced randomization (1:1:1) conducted at Melbourne Sexual Health Centre, Australia. Participants with symptomatic BV [Nugent Score (NS) = 7-10 or ≥3 Amsel's criteria and NS = 4-10], were randomly allocated to MTZ-Clind, MTZ-Prob or MTZ-Placebo and assessed at 1,2,3 and 6 months. MTZ and Clind were administered for 7 days and Prob and Placebo for 12 days. Primary outcome was BV recurrence (NS of 7-10) on self-collected vaginal-swabs over 6-months. Cumulative BV recurrence rates were compared between groups by Chi-squared statistics. Kaplan-Meier, log rank and Cox regression analyses were used to compare time until and risk of BV recurrence between groups. RESULTS: 450 18-50 year old females were randomized and 408 (91%), equally distributed between groups, provided ≥1 NS post-randomization and were included in analyses; 42 (9%) participants with no post-randomization data were excluded. Six-month retention rates were 78% (n = 351). One-month BV recurrence (NS 7-10) rates were 3.6% (5/140), 6.8% (9/133) and 9.6% (13/135) in the MTZ-Clind, MTZ-Prob and MTZ-Placebo groups respectively, p = 0.13. Hazard ratios (HR) for BV recurrence at one-month, adjusted for adherence to vaginal therapy, were 0.43 (95%CI 0.15-1.22) and 0.75 (95% CI 0.32-1.76) in the MTZ-Clind and MTZ-Prob groups compared to MTZ-Plac respectively. Cumulative 6-month BV recurrence was 28.2%; (95%CI 24.0-32.7%) with no difference between groups, p = 0.82; HRs for 6-month BV recurrence for MTZ-Clind and MTZ-Prob compared to MTZ-Plac, adjusted for adherence to vaginal therapy were 1.09(95% CI = 0.70-1.70) and 1.03(95% CI = 0.65-1.63), respectively. No serious adverse events occurred. CONCLUSION: Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin, or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic, does not reduce BV recurrence. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12607000350426