The Effect of Symmetrical, Hand-held Load Carriage on Thoracic Rotation during Gait: An Observational Study

Title: The Effect of Symmetrical, Hand-held Load Carriage on Thoracic Rotation during Gait: An Observational Study Authors: Danny J. McMillian, PT, DSc, OCS, CSCS ; Robert C. Bennett, SPT ; Claire E. Tenenbaum, SPT ; Daniel C. Winnwalker, SPT Affiliation: Physical Therapy Program, University of Puget Sound Purpose: During unloaded ambulation arm, trunk and leg motion produces reciprocal, anti-phase rotation between the pelvis and thoracic spine. Anti-phase rotation allows for efficient, stable gait patterns and promotes balanced segmental forces. Research demonstrates that several common factors cause in-phase thoracic spine and pelvic rotation resulting in decreased gait efficiency. Factors include load carriage, slow gait velocity, and locomotor pathologies that promote protective spinal stabilization such as low back pain and pregnancy-related pelvic girdle pain. Since painful spinal and pelvic conditions are frequently treated with physical therapy interventions that promote stabilization, clinicians should be cognizant of the degree to which such exercises may alter normal gait mechanics.A previous, as yet unpublished study from our lab has shown that gait mechanics transition from anti-phase to in-phase rotation with as little as 5% of an individual’s body weight carried as a asymmetrical hand-held load. The purpose of the current study was to establish if altered gait kinematics, specifically thoracic spinal rotation relative to the pelvis, occurs with symmetrical hand-held loads. Subjects: Adult volunteers, 18-30 years old, with no gait or health complications. Materials & Methods: Each subject walked at a cadence of 100 beats per minute for a distance of 48 feet and repeated seven different conditions three times in randomized order. The conditions were: 1) no load, 2) holding an empty canvas bag in each hand, 3) holding 2% of body weight (BW), 4) holding 4% BW, 5) holding 6% BW, 6) holding 8% BW, and 7) holding 10% BW. Each percentage of BW was carried bilaterally and subjects were blinded to conditions 2-7. Ten Bonita cameras recorded each condition at 120 hertz, and gait kinematics were analyzed with VICON Nexus 1.8.4 motion analysis system. In order to compare the average thoracic rotation relative to the pelvis for each condition a repeated measures ANOVA with Bonferroni adjustment was performed with alpha value p\u3c0.05. Results: Compared to condition 1 (unloaded walking), condition 2-7 demonstrated significant decrease in rotational angles of the thoracic spine relative to the pelvis (p\u3c0.001). Furthermore, condition 2 demonstrated a significant decrease in thoracic rotation as compared to conditions 5 (p\u3c0.004) and 7 (p\u3c0.034). Conclusion: Thoracic spine rotation decreases when walking with unloaded bags in each hand. Diminished rotation was likely due to decreasing arm swing. Consistent with the effects of muscular stabilization, increased load generally decreased rotation further. Clinical Relevance: This information is clinically applicable when working with individuals who have some degree of in-phase gait kinematics and need rehabilitation in order to return to activities that necessitate gait with hand-held loads. In these cases, clinicians should consider first reestablishing optimal transverse plane kinematics, then incorporating only the minimally necessary amount of hand-held load

Emotions and Complaining Behavior Following Service Failure

One feature of a democratic society is voice, especially the freedom to dissent. One form of dissent of relevance to organizational scholars is complaining, whether it be complaints from employee stakeholder groups or customer stakeholder groups. Despite the increased ability that the knowledge economy provides for people of all walks of life and nationalities to voice complaint, little is known about the antecedents and consequences of complaining. This paper addresses this issue with respect to customers' response to service failures. Specifically, this paper develops a conceptual model for service settings building upon a model of emotional and cognitive response formation to an affective event (Hartel, McColl-Kennedy & Bennett, 2002), and its source theory, Weiss and Cropanzano's (1995) Affective Events Theory (AET). We argue that when a service failure occurs, a number of cognitive and affective responses take place in consumers. The proposed model aims to operationalize affective responses to service failures in the marketplace. 'Affective response' refers to cognitive, emotional, behavioral and neuropsychological responses to emotional events. As such, the model makes explicit the relationships between and factors within each of these domains of affect expression

The Child and Parent Emotion Study: Protocol for a longitudinal study of parent emotion socialisation and child socioemotional development

Introduction:&nbsp;Parents shape child emotional competence and mental health via their beliefs about children&rsquo;s emotions, emotion-related parenting, the emotional climate of the family and by modelling emotion regulation skills. However, much of the research evidence to date has been based on small samples with mothers of primary school-aged children. Further research is needed to elucidate the direction and timing of associations for mothers and fathers/partners across different stages of child development. The Child and Parent Emotion Study (CAPES) aims to examine longitudinal associations between parent emotion socialisation, child emotion regulation and socioemotional adjustment at four time points from pregnancy to age 12 years. CAPES will investigate the moderating role of parent gender, child temperament and gender, and family background.Methods and analysis:&nbsp;CAPES recruited 2063 current parents from six English-speaking countries of a child 0&ndash;9 years and 273 prospective parents (ie, women/their partners pregnant with their first child) in 2018&ndash;2019. Participants will complete a 20&ndash;30 min online survey at four time points 12 months apart, to be completed in December 2022. Measures include validated parent-report tools assessing parent emotion socialisation (ie, parent beliefs, the family emotional climate, supportive parenting and parent emotion regulation) and age-sensitive measures of child outcomes (ie, emotion regulation and socioemotional adjustment). Analyses will use mixed-effects regression to simultaneously assess associations over three time-point transitions (ie, T1 to T2; T2 to T3; T3 to T4), with exposure variables lagged to estimate how past factors predict outcomes 12 months later.Ethics and dissemination:&nbsp;Ethics approval was granted by the Deakin University Human Research Ethics Committee and the Deakin University Faculty of Health Human Research Ethics Committee. We will disseminate results through conferences and open access publications. We will invite parent end users to co-develop our dissemination strategy, and discuss the interpretation of key findings prior to publication.Trial registeration:&nbsp;Protocol pre-registration: DOI 10.17605/OSF.IO/NGWUY.</jats:sec

Prevalence and Correlates of Youth Suicidal Ideation and Attempts: Evidence from the 2014 Ontario Child Health Study

© The Author(s) 2019. Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y (n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury

Developing a tool to support diagnostic delivery of dementia

It is increasingly recognised that there are challenges affecting the current delivery of dementia diagnoses. Steps are required to address this. Current good practice guidelines provide insufficient direction and interventions from other healthcare settings do not appear to fully translate to dementia care settings. This project has taken a sequential two-phase design to developing a tool specific to dementia diagnostic delivery. Interviews with 14 participants explored good diagnostic delivery. Thematic analysis produced key themes (overcoming barriers, navigation of multiple journeys and completing overt and covert tasks) that were used to inform the design of a tool for use by clinicians, patients and companions. The tool was evaluated for acceptability in focused group discussions with 13 participants, which indicated a desire to use the tool and that it could encourage good practice. Adaptations were highlighted and incorporated to improve acceptability. Future research is now required to further evaluate the tool

Saharan dust plume charging observed over the UK

A plume of Saharan dust and Iberian smoke was carried across the southern UK on 16th October 2017, entrained into an Atlantic cyclone which had originated as Hurricane Ophelia. The dust plume aloft was widely noticed as it was sufficiently dense to redden the visual appearance of the sun. Time series of backscatter from ceilometers at Reading and Chilbolton show two plumes: one carried upwards to 2.5 km, and another below 800m into the boundary layer, with a clear slot between. Steady descent of particles at about 50 cms−1 continued throughout the morning, and coarse mode particles reached the surface. Plumes containing dust are frequently observed to be strongly charged,often through frictional effects. This plume passed over atmospheric electric field sensors at Bristol, Chilbolton and Reading. Consistent measurements at these three sites indicated negative plume charge. The lower edge plume charge density was (−8.0±3.3) nCm−2, which is several times greater than that typical for stratiform water clouds, implying an active in situ charge generation mechanism such as turbulent triboelectrification. A meteorological radiosonde measuring temperature and humidity was launched into the plume at 1412 UTC, specially instrumented with charge and turbulence sensors. This detected charge in the boundary layer and in the upper plume region, and strong turbulent mixing was observed throughout the atmosphere’s lowest 4 km. The clear slot region, through which particles sedimented, was anomalously dry compared with modelled values, with water clouds forming intermittently in the air beneath. Electrical aspects of dust should be included in numerical models, particularly the charge-related effects on cloud microphysical properties, to accurately represent particle behaviour and transport

Neural Impact of Neighborhood Socioeconomic Disadvantage in Traumatically Injured Adults

Nearly 14 percent of Americans live in a socioeconomically disadvantaged neighborhood. Lower individual socioeconomic position (iSEP) has been linked to increased exposure to trauma and stress, as well as to alterations in brain structure and function; however, the neural effects of neighborhood SEP (nSEP) factors, such as neighborhood disadvantage, are unclear. Using a multi-modal approach with participants who recently experienced a traumatic injury (N = 185), we investigated the impact of neighborhood disadvantage, acute post-traumatic stress symptoms, and iSEP on brain structure and functional connectivity at rest. After controlling for iSEP, demographic variables, and acute PTSD symptoms, nSEP was associated with decreased volume and alterations of resting-state functional connectivity in structures implicated in affective processing, including the insula, ventromedial prefrontal cortex, amygdala, and hippocampus. Even in individuals who have recently experienced a traumatic injury, and after accounting for iSEP, the impact of living in a disadvantaged neighborhood is apparent, particularly in brain regions critical for experiencing and regulating emotion. These results should inform future research investigating how various levels of socioeconomic circumstances may impact recovery after a traumatic injury as well as policies and community-developed interventions aimed at reducing the impact of socioeconomic stressors

Racial Discrimination and Resting-State Functional Connectivity of Salience Network Nodes in Trauma-Exposed Black Adults in the United States

Importance For Black US residents, experiences of racial discrimination are still pervasive and frequent. Recent empirical work has amplified the lived experiences and narratives of Black people and further documented the detrimental effects of racial discrimination on both mental and physical health; however, there is still a need for further research to uncover the mechanisms connecting experiences of racial discrimination with adverse health outcomes. Objective To examine neurobiological mechanisms that may offer novel insight into the association of racial discrimination with adverse health outcomes. Design, Setting, and Participants This cross-sectional study included 102 Black adults who had recently experienced a traumatic injury. In the acute aftermath of the trauma, participants underwent a resting-state functional magnetic resonance imaging scan. Individuals were recruited from the emergency department at a Midwestern level 1 trauma center in the United States between March 2016 and July 2020. Data were analyzed from February to May 2021. Exposures Self-reported lifetime exposure to racial discrimination, lifetime trauma exposure, annual household income, and current posttraumatic stress disorder (PTSD) symptoms were evaluated. Main Outcomes and Measures Seed-to-voxel analyses were conducted to examine the association of racial discrimination with connectivity of salience network nodes (ie, amygdala and anterior insula). Results A total of 102 individuals were included, with a mean (SD) age of 33 (10) years and 58 (57%) women. After adjusting for acute PTSD symptoms, annual household income, and lifetime trauma exposure, greater connectivity between the amygdala and thalamus was associated with greater exposure to discrimination (t(97) = 6.05; false discovery rate (FDR)–corrected P = .03). Similarly, racial discrimination was associated with greater connectivity between the insula and precuneus (t(97) = 4.32; FDR-corrected P = .02). Conclusions and Relevance These results add to the mounting literature that racial discrimination is associated with neural correlates of vigilance and hyperarousal. The study findings extend this theory by showing that this association is apparent even when accounting for socioeconomic position, lifetime trauma, and symptoms of psychological distress related to an acute trauma

A prospective cohort study assessing clinical referral management & workforce allocation within a UK regional medical genetics service

Abstract Ensuring patient access to genomic information in the face of increasing demand requires clinicians to develop innovative ways of working. This paper presents the first empirical prospective observational cohort study of UK multi-disciplinary genetic service delivery. It describes and explores collaborative working practices including the utilisation and role of clinical geneticists and non-medical genetic counsellors. Six hundred and fifty new patients referred to a regional genetics service were tracked through 850 clinical contacts until discharge. Referral decisions regarding allocation of lead health professional assigned to the case were monitored, including the use of initial clinical contact guidelines. Significant differences were found in the cases led by genetic counsellors and those led by clinical geneticists. Around a sixth, 16.8% (109/650) of referrals were dealt with by a letter back to the referrer or re-directed to another service provider and 14.8% (80/541) of the remaining patients chose not to schedule an appointment. Of the remaining 461 patients, genetic counsellors were allocated as lead health professional for 46.2% (213/461). A further 61 patients did not attend. Of those who did, 86% (345/400) were discharged after one or two appointments. Genetic counsellors contributed to 95% (784/825) of total patient contacts. They provided 93.7% (395/432) of initial contacts and 26.8% (106/395) of patients were discharged at that point. The information from this study informed a planned service re-design. More research is needed to assess the effectiveness and efficiency of different models of collaborative multi-disciplinary working within genetics services. Keywords (MeSH terms) Genetic Services, Genetic Counseling, Interdisciplinary Communication, Cohort Studies, Delivery of Healthcare, Referral and Consultation

Infrastructural Speculations: Tactics for Designing and Interrogating Lifeworlds

This paper introduces “infrastructural speculations,” an orientation toward speculative design that considers the complex and long-lived relationships of technologies with broader systems, beyond moments of immediate invention and design. As modes of speculation are increasingly used to interrogate questions of broad societal concern, it is pertinent to develop an orientation that foregrounds the “lifeworld” of artifacts—the social, perceptual, and political environment in which they exist. While speculative designs often imply a lifeworld, infrastructural speculations place lifeworlds at the center of design concern, calling attention to the cultural, regulatory, environmental, and repair conditions that enable and surround particular future visions. By articulating connections and affinities between speculative design and infrastructure studies research, we contribute a set of design tactics for producing infrastructural speculations. These tactics help design researchers interrogate the complex and ongoing entanglements among technologies, institutions, practices, and systems of power when gauging the stakes of alternate lifeworlds