Screening for health risks: A social science perspective

Health screening promises to reduce risks to individuals via probabilistic sifting of populations for medical conditions. The categorisation and selection of 'conditions' such as cardiovascular events, dementia and depression for screening itself requires prior interpretive labour which usually remains unexamined. Screening systems can take diverse organisational forms and varying relationships to health status, as when purported disease precursors, for example 'pre-cancerous' polyps, or supposed risk factors, such as high cholesterol themselves, become targets for screening. Screening at best yields small, although not necessarily unworthwhile, net population health gains. It also creates new risks, leaving some individuals worse-off than if they had been left alone. The difficulties associated with attempting to measure small net gains through randomised controlled trials are sometimes underestimated. Despite endemic doubts about its clinical utility, bibliometric analysis of published papers shows that responses to health risks are coming to be increasingly thought about in terms of screening. This shift is superimposed on a strengthening tendency to view health through the lens of risk. It merits further scrutiny as a societal phenomenon

The Filing and Briefing of Cross-Motions in State and Federal Court

Misunderstandings regarding the definition of a crossmotion often lead to problems during the filing and briefing of cross-motions in state and federal courts. This article focuses on defining and illustrating the elements of a proper cross-motion, identifying and illustrating common problems caused by the filing and briefing of improper crossmotions, and offering solutions to those problems. As most commonly understood by judges and practitioners, a cross-motion in state or federal court possesses three elements: (1) it is filed against the originally moving party; (2) it is filed by a party against whom the original motion was filed; and (3) it requests an order similar to that requested by the originally moving party against the cross-moving party. Common problems posed by the filing and briefing of improper cross-motions in state and federal court include (1) a violation of the action’s motion-filing deadline, (2) a violation of the court’s proscription against the filing of replies on cross-motions, (3) a violation of the court’s proscription against the filing of sur-replies on dispositive motions, and (4) a violation of the court’s page limitation on memoranda of law. Possible solutions to those common problems include (1) filing a motion before the opposing party files its motion, (2) requesting leave to depart from the action’s scheduling order or the court’s local rules, (3) moving to strike the improper cross-motion, and (4) in the context of pleading amendments, filing a timely amended complaint rather than a cross-motion for leave to file an amended complaint in response to a motion to dismiss for failure to state a claim

InSb charge coupled infrared imaging device: The 20 element linear imager

The design and fabrication of the 8585 InSb charge coupled infrared imaging device (CCIRID) chip are reported. The InSb material characteristics are described along with mask and process modifications. Test results for the 2- and 20-element CCIRID's are discussed, including gate oxide characteristics, charge transfer efficiency, optical mode of operation, and development of the surface potential diagram

Missing data in randomized controlled trials testing palliative interventions pose a significant risk of bias and loss of power: a systematic review and meta-analyses

Objectives To assess the risk posed by missing data (MD) to the power and validity of trials evaluating palliative interventions. Study Design and Setting A systematic review of MD in published randomized controlled trials (RCTs) of palliative interventions in participants with life-limiting illnesses was conducted, and random-effects meta-analyses and metaregression were performed. CENTRAL, MEDLINE, and EMBASE (2009-2014) were searched with no language restrictions. Results One hundred and eight RCTs representing 15,560 patients were included. The weighted estimate for MD at the primary endpoint was 23.1% (95% confidence interval [CI] 19.3, 27.4). Larger MD proportions were associated with increasing numbers of questions/tests requested (odds ratio [OR] , 1.19; 95% CI 1.05, 1.35) and with longer study duration (OR, 1.09; 95% CI 1.02, 1.17). Meta-analysis found evidence of differential rates of MD between trial arms, which varied in direction (OR, 1.04; 95% CI 0.90, 1.20; I 2 35.9, P = 0.001). Despite randomization, MD in the intervention arms (vs. control) were more likely to be attributed to disease progression unrelated to the intervention (OR, 1.31; 95% CI 1.02, 1.69). This was not the case for MD due to death (OR, 0.92; 95% CI 0.78, 1.08). Conclusion The overall proportion and differential rates and reasons for MD reduce the power and potentially introduce bias to palliative care trials

Building Bridges: Restructuring Online Library Tutorials to Span the Generation Gap and Meet the Needs of Millennial Students

This session will discuss the learning characteristics of Millennial students, and how online library tutorials can produce successful information literacy learning outcomes for this unique generation. In 2009, we transformed Searchpath , the 2003 PRIMO award-winning online library tutorial, into ResearchPath, a dynamic audio, visual and kinesthetic experience with the Millennial user in mind. We will share the results of the research we conducted at Western Michigan University Libraries to measure the success of our intended learning outcomes, as well as the qualitative user feedback which we gathered. We will recommend strategies for others interested in developing online tutorials geared towards building bridges to the unique learning styles of Millennial learners

A practical guide for the study of human and murine sebaceous glands in situ

The skin of most mammals is characterised by the presence of sebaceous glands (SGs), whose predominant constituent cell population is sebocytes, that is, lipid-producing epithelial cells, which develop from the hair follicle. Besides holocrine sebum production (which contributes 90% of skin surface lipids), multiple additional SG functions have emerged. These range from antimicrobial peptide production and immunomodulation, via lipid and hormone synthesis/metabolism, to the provision of an epithelial progenitor cell reservoir. Therefore, in addition to its involvement in common skin diseases (e.g. acne vulgaris), the unfolding diversity of SG functions, both in skin health and disease, has raised interest in this integral component of the pilosebaceous unit. This practical guide provides an introduction to SG biology and to relevant SG histochemical and immunohistochemical techniques, with emphasis placed on in situ evaluation methods that can be easily employed. We propose a range of simple, established markers, which are particularly instructive when addressing specific SG research questions in the two most commonly investigated species in SG research, humans and mice. To facilitate the development of reproducible analysis techniques for the in situ evaluation of SGs, this methods review concludes by suggesting quantitative (immuno-)histomorphometric methods for standardised SG evaluation

In Emerging Adulthood, Perceived Stress is Linked to Poor Diet Quality

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THE PSYCHOLOGICAL AND PHYSIOLOGICAL EFFECTS OF MAKING WEIGHT IN INTERNATIONAL LEVEL TAEKWONDO ATHLETES

International standard Taekwondo athletes are unique, given they are required to compete in two differing weight categories for both World (WT) and Olympic (OG) events, which have some of the largest differences amongst other making weight combat sports. Typically, this demographic will lose body mass (BM) via acute and chronic methods, in order to make the lower limit of a category. Despite a raft of literature examining the frequency, magnitude, occurrence and influences of these practices, the motivations to engage in this convention are still largely unknown. Additionally, few studies have investigated this population for both body composition and activity energy expenditures (AEE), utilising either criterion or field based measurement tools during periods of BM loss and as such, these athletes may be susceptible to low energy availability (LEA) leading to relative energy deficiency in sport (RED-S). Therefore, the main aim of this thesis was to examine the psychological and physiological health and performance consequences of making weight in international standard Taekwondo athletes. Study 1 examined the frequency, magnitude, occurrence and influences of BM loss and making weight practices, in a cohort of 106 male and female Cadet, Junior and Senior Taekwondo athletes, directly after a weigh in at a major national championships. In agreement with previous research, there were no differences between sexes, however, for the first time this study highlighted key disparities in the frequency, magnitude and occurrence of BM loss and making weight practices between age groups. Additionally for the first time, the magnitudes between WT and OG weight category requirements were elucidated, showing relative BM losses which are far higher than previously characterised in this demographic. This study also highlighted the key stakeholder groups influencing the engagement in these practices, which in younger age groups was shown to be predominantly parents. Finally, it was conveyed that the nutritional and ergogenic dietary supplement knowledge of this group was largely poor when compared to optimal guidelines. In Study 2, semi structured interviews were conducted with the key stakeholder groups (5 athletes, 5 coaches, 5 parents), as identified in Study 1. Again, high magnitudes of BM loss were described by all stakeholders in agreement with Study 1. Furthermore, each stakeholder group described their perceptions of the making weight process, with all expressing it can negatively affect health and performance, but was necessary to enhance advantages in competition. The nutritional and ergogenic dietary supplement knowledge of all stakeholder groups was poor as described in Study 1. All stakeholders agreed that education, targeted particularly at the coaches, alongside improvements in national and global federation making weight policies, were required to improve current practice. Study 3 investigated the requirements of BM losses between the OG and WT categories in 18 international standard Taekwondo athletes, within 4 days prior to a competition weigh in. This emphasised the need to engage in extreme making weight practices in order to meet elected OG category allowances, as described in Studies 1 and 2. Additionally, the body composition of these athletes was examined utilising both dual x-ray absorptiometry (DXA) and various sum of skinfold (ΣSKf) fat mass percentage (FM%) equations. For the first time, this study highlighted body compositional differences between athletes of varying weight categories, where all of the cohort had low FM% (13% loss of BM for competition. Utilising the findings and methods of Studies 3 and 4, energy availability (EA) was examined and measures were taken throughout to examine the potential for RED-S consequences on both health and performance parameters. The athlete successfully achieved their elected weight category limit, with minimal negative associations of RED-S syndromes exhibited on markers of metabolic, endocrine, cardiovascular, bone turnover and psychological functions. Additionally there were no negative effects apparent on either tested maximal dynamic strength/power and cardiorespiratory conditioning or competitive performances. However, post competition there was a significant rebound hyperphagic response, congruent with BM overshoot and despite the success of the intervention, this should be given further consideration in the future. This thesis serves as a means to improve the making weight practices of international standard Taekwondo athletes, by affording the ability to examine both body composition and AEE in the field, whilst providing a safe and effective intervention to lose BM without the negative associations of RED-S. However, despite this, the findings of this thesis also serve as a call to action to the national and global governing federations, in enhancing the education of key stakeholders in this sport, whilst considering the addition of more weight categories to reduce the incidence of extreme and dangerous making weight practices throughout older age divisions

Determining concentric and eccentric force–velocity profiles during squatting.

The force–velocity relationship of muscular contraction has been extensively studied. However, previous research has focussed either on isolated muscle or single-joint movements, whereas human movement consists of multi-joint movements (e.g. squatting). Therefore, the purpose of this study was to investigate the force–velocity relationship of isovelocity squatting. Fifteen male participants (24±2 years, 79.8±9.1 kg, 177.5±6 cm) performed isovelocity squats on a novel motorised isovelocity device (Kineo Training System) at three concentric (0.25, 0.5, and 0.75 m s−1) and three eccentric velocities (−0.25, −0.5, and −0.75 m s−1). Peak vertical ground reaction forces, that occurred during the isovelocity phase, were collected using dual force plates (2000 Hz) (Kistler, Switzerland). The group mean squat force–velocity profile conformed to the typical in vivo profile, with peak vertical ground reaction forces during eccentric squatting being 9.5 ± 19% greater than isometric (P = 0.037), and occurring between −0.5 and −0.75 m s−1. However, large inter-participant variability was identified (0.84–1.62 × isometric force), with some participants being unable to produce eccentric forces greater than isometric. Sub-group analyses could not identify differences between individuals who could/could not produce eccentric forces above isometric, although those who could not tended to be taller. These finding suggest that variability exists between participants in the ability to generate maximum eccentric forces during squatting, and the magnitude of eccentric increase above isometric cannot be predicted solely based on a concentric assessment. Therefore, an assessment of eccentric capabilities may be required prior to prescribing eccentric-specific resistance training