Orthotic management of cerebral palsy : recommendations from a consensus conference

An international multidisciplinary group of healthcare professionals and researchers participated in a consensus conference on the management of cerebral palsy, convened by the International Society for Prosthetics and Orthotics. Participants reviewed the evidence and considered contemporary thinking on a range of treatment options including physical and occupational therapy, and medical, surgical and orthotic interventions. The quality of many of the reviewed papers was compromised by inadequate reporting and lack of transparency, in particular regarding the types of patients and the design of the interventions being evaluated. Substantial evidence suggests that ankle-foot orthoses (AFOs) that control the foot and ankle in stance and swing phases can improve gait efficiency in ambulant children (GMFCS levels I-III). By contrast, little high quality evidence exists to support the use of orthoses for the hip, spine or upper limb. Where the evidence for orthosis use was not compelling consensus was reached on recommendations for orthotic intervention. Subsequent group discussions identified recommendations for future research. The evidence to support using orthoses is generally limited by the brevity of follow-up periods in research studies; hence the extent to which orthoses may prevent deformities developing over time remains unclear. The full report of the conference can be accessed free of charge at www.ispoint.org

Linking the Epigenome with Exposure Effects and Susceptibility: The Epigenetic Seed and Soil Model

The epigenome is a dynamic mediator of gene expression that shapes the way that cells, tissues, and organisms respond to their environment. Initial studies in the emerging field of “toxicoepigenetics” have described either the impact of an environmental exposure on the epigenome or the association of epigenetic signatures with the onset or progression of disease; however, the majority of these pioneering studies examined the relationship between discrete epigenetic modifications and the effects of a single environmental factor. Although these data provide critical blocks with which we construct our understanding of the role of the epigenome in susceptibility and disease, they are akin to individual letters in a complex alphabet that is used to compose the language of the epigenome. Advancing the use of epigenetic data to gain a more comprehensive understanding of the mechanisms underlying exposure effects, identify susceptible populations, and inform the next generation risk assessment depends on our ability to integrate these data in a way that accounts for their cumulative impact on gene regulation. Here we will review current examples demonstrating associations between the epigenetic impacts of intrinsic factors, such as such as age, genetics, and sex, and environmental exposures shape the epigenome and susceptibility to exposure effects and disease. We will also demonstrate how the “epigenetic seed and soil” model can be used as a conceptual framework to explain how epigenetic states are shaped by the cumulative impacts of intrinsic and extrinsic factors and how these in turn determine how an individual responds to subsequent exposure to environmental stressors

Late Light Curves of Normal Type Ia Supernovae

We present late-epoch optical photometry (BVRI) of seven normal/super-luminous Type Ia supernovae: SN 2000E, SN 2000ce, SN 2000cx, SN 2001C, SN 2001V, SN 2001bg, SN 2001dp. The photometry of these objects was obtained using a template subtraction method to eliminate galaxy light contamination during aperture photometry. We show the optical light curves of these supernovae out to epochs of up to ~640 days after the explosion of the supernova. We show a linear decline in these data during the epoch of 200-500 days after explosion with the decline rate in the B,V,& R bands equal to about 1.4 mag/100 days, but the decline rate of the I-band is much shallower at 0.94 mag/100 days.Comment: 33 pages, 11 figures, Accepted for publication in The Astronomical Journa

Evaluation of the Wellspring Model for Improving Nursing Home Quality

Examines how successfully the Wellspring model improved the quality of care for residents of eleven nonprofit nursing homes in Wisconsin. Looks at staff turnover, and evaluates the impact on facilities, employees, residents, and cost

Uniformity of V minus Near Infrared Color Evolution of Type Ia Supernovae, and Implications for Host Galaxy Extinction Determination

From an analysis of SNe 1972E, 1980N, 1981B, 1981D, 1983R, 1998bu, 1999cl, and 1999cp we find that the intrinsic V-K colors of Type Ia SNe with multi-color light curve shape (MLCS) parameter -0.4 < Delta < +0.2 suggest a uniform color curve. V-K colors become bluer linearly with time from roughly one week before B-band maximum until one week after maximum, after which they redden linearly until four weeks after maximum. V-H colors exhibit very similar color evolution. V-J colors exhibit slightly more complex evolution, with greater scatter. The existence of V minus near infrared color relations allows the construction of near infrared light curve templates that are an improvement on those of Elias et al. (1985). We provide optical BVRI and infrared JHK photometry of the Type Ia supernovae 1999aa, 1999cl, and 1999cp. SN 1999aa is an overluminous "slow decliner" (with Delta = -0.47 mag). SN 1999cp is a moderately bright SN unreddened in its host. SN 1999cl is extremely reddened in its host. The V minus near infrared colors of SN 1999cl yield A_V = 2.01 +/- 0.11 mag. This leads to a distance for its host galaxy (M 88) in agreement with other distance measurements for members of the Virgo cluster.Comment: 57 pages, 13 postscript figures, to appear in the August 20, 2000, issue of the Astrophysical Journal. Contains updated references and a number of minor corrections dealt with when page proofs were correcte

Observation of enhanced rate coefficients in the H2+_2^+ + H2_2 →\rightarrow H3+_3^+ + H reaction at low collision energies

The energy dependence of the rate coefficient of the H$_2^+\ + {\rm H}_2 \rightarrow {\rm H}_3^+ + {\rm H}$ reaction has been measured in the range of collision energies between $k_\mathrm{B}\cdot 10$ K and $k_\mathrm{B}\cdot 300$ mK. A clear deviation of the rate coefficient from the value expected on the basis of the classical Langevin-capture behavior has been observed at collision energies below $k_\mathrm{B}\cdot 1$ K, which is attributed to the joint effects of the ion-quadrupole and Coriolis interactions in collisions involving ortho-H$_2$ molecules in the $j = 1$ rotational level, which make up 75% of the population of the neutral H$_2$ molecules in the experiments. The experimental results are compared to very recent predictions by Dashevskaya, Litvin, Nikitin and Troe (J. Chem. Phys., in press), with which they are in agreement.Comment: 14 pages, 3 figure

Near Infrared Spectra of Type Ia Supernovae

We report near infrared (NIR) spectroscopic observations of twelve ``Branch-normal'' Type Ia supernovae (SNe Ia) which cover the wavelength region from 0.8-2.5 microns. Our sample more than doubles the number of SNe Ia with published NIR spectra within three weeks of maximum light. The epochs of observation range from thirteen days before maximum light to eighteen days after maximum light. A detailed model for a Type Ia supernovae is used to identify spectral features. The Doppler shifts of lines are measured to obtain the velocity and, thus, the radial distribution of elements. The NIR is an extremely useful tool to probe the chemical structure in the layers of SNe Ia ejecta. This wavelength region is optimal for examining certain products of the SNe Ia explosion that may be blended or obscured in other spectral regions. We identify spectral features from MgII, CaII, SiII, FeII, CoII, NiII and possibly MnII. We find no indications for hydrogen, helium or carbon in the spectra. The spectral features reveal important clues about the physical characteristics of SNe Ia. We use the features to derive upper limits for the amount of unburned matter, to identify the transition regions from explosive carbon to oxygen burning and from partial to complete silicon burning, and to estimate the level of mixing during and after the explosion.Comment: 44 pages, 7 figures, 3 tables, accepted by Ap

Morale is high in acute inpatient psychiatry

Background: Morale on acute psychiatric wards has been considered to be problematic, and is reported to contribute to low quality patient care. Aim: To assess the relationship of staff morale to patient, service environment, physical environment, patient routines, conflict, containment, staff demographics, and staff group variables. Method: A multivariate cross sectional study was undertaken collecting data on morale and other variables on 136 acute admission psychiatric wards in England. Results: Morale was higher than published comparison samples. Length of time in post was correlated with low morale, and qualified nurses had higher emotional exhaustion but also higher personal accomplishment. The level of verbal abuse on a ward was associated with low morale, as was a higher level of social deprivation among patients. Higher levels of order and organisation correlated with better morale. Conclusions: Clear policies relating to the management of verbal abuse by patients, high levels of order and organisation, and staff rotation and education, may all support high morale. Acute inpatient psychiatry is generally a happy and rewarding work environment, and identified problems are likely to be due to other factors