Best evidence osteoarthritis care: What are the recommendations and what Is needed to improve practice?

This article provides an overview of osteoarthritis (OA) management recommendations and strategies to improve clinical practice concordance with clinical guidelines. In many countries, the primary point of care for a person with OA is typically general practitioners and physiotherapists. Optimal primary care focuses on core OA treatments, namely education for self-management and lifestyle interventions encompassing increased physical activity, therapeutic exercise, and weight loss (if indicated). Quality indicators are used in clinical practice and research to determine the quality of care and in some settings, are used as knowledge translation tools to address existing evidence-to-practice gaps

Attentional Processing in C57BL/6J Mice Exposed to Developmental Vitamin D Deficiency

Epidemiological evidence suggests that Developmental Vitamin D (DVD) deficiency is associated with an increased risk of schizophrenia. DVD deficiency in mice is associated with altered behaviour, however there has been no detailed investigation of cognitive behaviours in DVD-deficient mice. The aim of this study was to determine the effect of DVD deficiency on a range of cognitive tasks assessing attentional processing in C57BL/6J mice. DVD deficiency was established by feeding female C57BL/6J mice a vitamin D-deficient diet from four weeks of age. After six weeks on the diet, vitamin D-deficient and control females were mated with vitamin D-normal males and upon birth of the pups, all dams were returned to a diet containing vitamin D. The adult offspring were tested on a range of cognitive behavioural tests, including the five-choice serial reaction task (5C-SRT) and five-choice continuous performance test (5C-CPT), as well as latent inhibition using a fear conditioning paradigm. DVD deficiency was not associated with altered attentional performance on the 5C-SRT. In the 5C-CPT DVD-deficient male mice exhibited an impairment in inhibiting repetitive responses by making more perseverative responses, with no changes in premature or false alarm responding. DVD deficiency did not affect the acquisition or retention of cued fear conditioning, nor did it affect the expression of latent inhibition using a fear conditioning paradigm. DVD-deficient mice exhibited no major impairments in any of the cognitive domains tested. However, impairments in perseverative responding in DVD-deficient mice may indicate that these animals have specific alterations in systems governing compulsive or reward-seeking behaviour

Monthly quasi-periodic eruptions from repeated stellar disruption by a massive black hole

In recent years, searches of archival X-ray data have revealed galaxies exhibiting nuclear quasi-periodic eruptions with periods of several hours. These are reminiscent of the tidal disruption of a star by a supermassive black hole. The repeated, partial stripping of a white dwarf in an eccentric orbit around an ~105 M⊙ black hole provides an attractive model. A separate class of periodic nuclear transients, with much longer timescales, have recently been discovered optically and may arise from the partial stripping of a main-sequence star by an ~107 M⊙ black hole. No clear connection between these classes has been made. We present the discovery of an X-ray nuclear transient that shows quasi-periodic outbursts with a period of weeks. We discuss possible origins for the emission and propose that this system bridges the two existing classes outlined above. This discovery was made possible by the rapid identification, dissemination and follow-up of an X-ray transient found by the new live Swift-XRT transient detector, demonstrating the importance of low-latency, sensitive searches for X-ray transients

Protein Expression in the Nucleus Accumbens of Rats Exposed to Developmental Vitamin D Deficiency

Introduction: Developmental vitamin D (DVD) deficiency is a candidate risk factor for schizophrenia. Animal models have confirmed that DVD deficiency is associated with a range of altered genomic, proteomic, structural and behavioural outcomes in the rat. Because the nucleus accumbens has been implicated in neuropsychiatric disorders, in the current study we examined protein expression in this region in adult rats exposed to DVD deficienc

Early star-forming galaxies and the reionization of the Universe

Star forming galaxies represent a valuable tracer of cosmic history. Recent observational progress with Hubble Space Telescope has led to the discovery and study of the earliest-known galaxies corresponding to a period when the Universe was only ~800 million years old. Intense ultraviolet radiation from these early galaxies probably induced a major event in cosmic history: the reionization of intergalactic hydrogen. New techniques are being developed to understand the properties of these most distant galaxies and determine their influence on the evolution of the universe.Comment: Review article appearing in Nature. This posting reflects a submitted version of the review formatted by the authors, in accordance with Nature publication policies. For the official, published version of the review, please see http://www.nature.com/nature/archive/index.htm

Development of a core capability framework for qualified health professionals to optimise care for people with osteoarthritis: an OARSI initiative

Summary Objective Develop a generic trans-disciplinary, skills-based capability framework for health professionals providing care for people with OA. Design e-Delphi survey. An international inter-professional Delphi Panel (researchers; clinicians; consumer representatives) considered a draft framework (adapted from elsewhere) of 131 specific capabilities mapped to 14 broader capability areas across four domains (A: person-centred approaches; B: assessment, investigation and diagnosis; C: management, interventions and prevention; D: service and professional development). Over three rounds, the Panel rated their agreement (Likert or numerical rating scales) on whether each specific capability in Domains B and C was essential (core) for all health professionals when providing care for all people with OA. Those achieving consensus (=80% of Panel) rating of = seven out of ten (Round 3) were retained. Generic domains (A and D) were included in the final framework and amended based on Panel comments. Results 173 people from 31 countries, spanning 18 disciplines and including 26 consumer representatives, participated. The final framework comprised 70 specific capabilities across 13 broad areas i) communication; ii) person-centred care; iii) history-taking; iv) physical assessment; v) investigations and diagnosis; vi) interventions and care planning; vii) prevention and lifestyle interventions; viii) self-management and behaviour change; ix) rehabilitative interventions; x) pharmacotherapy; xi) surgical interventions; xii) referrals and collaborative working; and xiii) evidence-based practice and service development). Conclusion Experts agree that health professionals require an array of skills in person-centred approaches; assessment, investigation and diagnosis; management, interventions and prevention; and service and professional development to provide optimal care for people with OA

Rapid Evolution in the Most Luminous Galaxies During the First 900 Million Years

The first 900 million years (Myr) to redshift z~6 (the first seven per cent of the age of the Universe) remains largely unexplored for the formation of galaxies. Large samples of galaxies have been found at z~6, but detections at earlier times are uncertain and unreliable. It is not at all clear how galaxies built up from the first stars when the Universe was ~300 Myr old (z~12-15) to z~6, just 600 Myr later. Here we report the results of a search for galaxies at z~7-8, about 700 Myr after the Big Bang, using the deepest near-infrared and optical images ever taken. Under conservative selection criteria we find only one candidate galaxy at z~7-8, where ten would be expected if there were no evolution in the galaxy population between z~7-8 and z~6. Using less conservative criteria, there are four candidates, where 17 would be expected with no evolution. This demonstrates that very luminous galaxies are quite rare 700 Myr after the Big Bang. The simplest explanation is that the Universe is just too young to have built up many luminous galaxies at z~7-8 by the hierarchical merging of small galaxies.Comment: Accepted for publication in Nature, 20 pages, 5 figures, 2 tables (includes Supplementary Information), replaced to match version in pres

Early life vitamin D depletion alters the postnatal response to skeletal loading in growing and mature bone

There is increasing evidence of persistent effects of early life vitamin D exposure on later skeletal health; linking low levels in early life to smaller bone size in childhood as well as increased fracture risk later in adulthood, independently of later vitamin D status. A major determinant of bone mass acquisition across all ages is mechanical loading. We tested the hypothesis in an animal model system that early life vitamin D depletion results in abrogation of the response to mechanical loading, with consequent reduction in bone size, mass and strength during both childhood and adulthood. A murine model was created in which pregnant dams were either vitamin D deficient or replete, and their offspring moved to a vitamin D replete diet at weaning. Tibias of the offspring were mechanically loaded and bone structure, extrinsic strength and growth measured both during growth and after skeletal maturity. Offspring of vitamin D deplete mice demonstrated lower bone mass in the non loaded limb and reduced bone mass accrual in response to loading in both the growing skeleton and after skeletal maturity. Early life vitamin D depletion led to reduced bone strength and altered bone biomechanical properties. These findings suggest early life vitamin D status may, in part, determine the propensity to osteoporosis and fracture that blights later life in many individuals

Small but crucial : the novel small heat shock protein Hsp21 mediates stress adaptation and virulence in Candida albicans

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