Evidence-Based Use of Cold for Plantar Fasciitis

Objective The purpose of this study was to examine the effect of cold applied the night before or in the morning on pain and symptoms of plantar fasciitis. Design Experimental study. Methods Thirty subjects with plantar fasciitis were recruited for this study. Subjects with plantar fasciitis either had no intervention, cold applied (20 minutes) at night before bed, or 20 minutes in the morning upon wakening. Plantar fascia tenderness and pain were evaluated. There were ten subjects in each group. Measures included visual analog scale, plantar facial thickness via high resolution ultrasound, algometer measure, and range of motion of the ankle and foot. There were 3 groups of 10 subjects, control (no intervention), cold the night before bed, and cold in the morning before rising. Results The greatest relief of symptoms was cold used at bedtime the night before the measurements. Cold used in the morning was not as effective as cold used in the evening before bed. Cold use reduced the thickness of the plantar fascia and irritation. There was a 13% reduction in plantar fascia thickness with cold the night before (p\u3c0.05), a 44% reduction in pain and an 86 % increase in the force that could be applied to the bottom of the foot without pain (p\u3c0.05). Conclusions Cold applied for 20 minutes prior bedtime is effective for reduced symptomology caused by plantar fascia inflammation

Occupational Therapy Interventions to Optimize Functional Use of the Upper Extremity After Peripheral Nerve Injury: A Systematic Review

PURPOSE: Peripheral nerve injuries are a distinct group of injuries that are commonly caused by motor vehicle accidents, falls, industrial accidents, household accidents, and penetrating trauma (Kamble et al., 2019). A peripheral nerve injury can affect an individual’s daily occupations and routines due to unrelenting pain, loss of sensation, and/or burning sensations. Peripheral nerve injuries can result in motor loss and subsequent muscle imbalance which can create functional loss (Chae et al., 2020). The purpose of this systematic review was to provide occupational therapists with evidence supporting the use of interventions to increase the functional use of the upper extremity after peripheral nerve injury. DESIGN: We conducted a systematic review and included studies relevant to peripheral nerve injury, functional use of the upper extremity, and interventions within the scope of occupational therapy. All articles included were published within the last decade. METHOD: We reviewed 31 titles and abstracts from MEDLINE, CINAHL, Embase, and Scopus databases and retrieved 11 full-text articles. Six met inclusion criteria. To determine the strength of evidence, we used the U.S. Preventative Services Task Force levels of certainty and grade definitions. RESULTS: Three themes emerged: mirror therapy, sensory re-education, and the use of an orthosis. Three level I studies, and one level II study reported on the effectiveness of mirror therapy interventions. These studies provide moderate strength of evidence supporting the use of mirror therapy for improving upper limb function after peripheral nerve injury. One level II study reported on the effectiveness of sensory re-education interventions. Based on this study, sensory re-education is another supported intervention for improving functional outcomes of the upper limb after a peripheral nerve injury. However, this is based on low strength of evidence. One level IV study reported on the effectiveness of orthosis interventions. Using a volar wrist orthosis to enhance upper limb functional use is supported for treatment of Carpal Tunnel Syndrome but is found to be disadvised for ulnar nerve injuries, based on low strength of evidence provided by this study. More evidence is needed to determine the effectiveness of this intervention. CONCLUSION: Based on moderate level of evidence, mirror therapy is a recommended intervention for improving functional outcomes of the upper limb after a peripheral nerve injury. These findings suggest that occupational therapists should be well-educated and trained in mirror therapy procedures and protocols in order to provide best practice to increase functional use of the upper limb after peripheral nerve injury. Sensory re-education is another recommended intervention to improve functional outcomes of the upper limb after a peripheral nerve injury that can be considered on a case-by-case basis. Due to limited literature, future research in the area of peripheral neuropathy interventions within the scope of occupational therapy should focus on increasing sample size using high quality study designs and developing a more standardized mirror therapy protocol.https://digitalcommons.unmc.edu/cahp_ot_sysrev/1003/thumbnail.jp

The Effect of BMI on Oxygen Saturation at Rest and During Mild Walking

Eighty one subjects were examined for the relationship between BMI, body fat, arterial oxygen saturation and arterial PO2 with the subjects at rest and after 5 minutes of walking on a treadmill ergometer at 3 mph at a 3% grade. They had BMIs between 19 and 50. All subjects were free of cardiovascular disease and had normal blood pressure making it safe for them to participate in mild exercise. They were all able to walk for at least 10 minutes without cardiovascular complications and were not taking any medications that altered the autonomic nervous system. The age was between 22 and 68. The results showed that above a BMI of about 30, there was an inverse relationship between BMI and oxygen saturation in fingertip blood (correlation -0.81.

Recruitment, growth and mortality of an Antarctic hexactinellid sponge, Anoxycalyx joubini.

Polar ecosystems are sensitive to climate forcing, and we often lack baselines to evaluate changes. Here we report a nearly 50-year study in which a sudden shift in the population dynamics of an ecologically important, structure-forming hexactinellid sponge, Anoxycalyx joubini was observed. This is the largest Antarctic sponge, with individuals growing over two meters tall. In order to investigate life history characteristics of Antarctic marine invertebrates, artificial substrata were deployed at a number of sites in the southern portion of the Ross Sea between 1967 and 1975. Over a 22-year period, no growth or settlement was recorded for A. joubini on these substrata; however, in 2004 and 2010, A. joubini was observed to have settled and grown to large sizes on some but not all artificial substrata. This single settlement and growth event correlates with a region-wide shift in phytoplankton productivity driven by the calving of a massive iceberg. We also report almost complete mortality of large sponges followed over 40 years. Given our warming global climate, similar system-wide changes are expected in the future

Liberal market economies, business, and political finance: Britain under New Labour

The extent and nature of business financing of parties is an important feature of political finance. Britain’s transparent and permissive regulatory system provides an excellent opportunity to study business financing of parties. Business donations have been very important to the Conservative party over the last decade, and of only marginal importance to Labour. Unlike other Conservative contributors, business donors are more likely to contribute when the party is popular. In contrast to the previous period of Conservative government, the biggest British businesses tended to abstain from political finance under New Labour. However, their bias towards the Conservatives is affected by the party’s popularity and the closeness of an election. Britain shares the political importance of business financing of parties and its mixture of ideological and pragmatic motivations with other liberal market economies. However, in Britain the bias towards the right is much stronger and the role of big business more marginal

Spin down of protostars through gravitational torques

Young protostars embedded in circumstellar discs accrete from an angular momentum-rich mass reservoir. Without some braking mechanism, all stars should be spinning at or near break-up velocity. In this paper, we perform simulations of the self-gravitational collapse of an isothermal cloud using the ORION adaptive mesh refinement code and investigate the role that gravitational torques might play in the spin-down of the dense central object. While magnetic effects likely dominate for low mass stars, high mass and Population III stars might be less well magnetised. We find that gravitational torques alone prevent the central object from spinning up to more than half of its breakup velocity, because higher rotation rates lead to bar-like deformations that enable efficient angular momentum transfer to the surrounding medium. We also find that the long-term spin evolution of the central object is dictated by the properties of the surrounding disc. In particular, spiral modes with azimuthal wavenumber $m=2$ couple more effectively to its spin than the lopsided $m=1$ mode, which was found to inhibit spin evolution. We suggest that even in the absence of magnetic fields, gravitational torques may provide an upper limit on stellar spin, and that moderately massive circumstellar discs can cause long-term spin down.Comment: 13 pages, 17 figures, 1 table. Accepted by MNRAS. Updated reference

Statement on the Effects of Law Enforcement in School Settings

School-based law enforcement (SBLE) have become increasingly common in U.S. schools over recent decades despite the controversy surrounding their presence and lack of consensus around their associated benefits and harms. Drawing on the history and evidence base regarding SBLE, we advocate for an end to SBLE programs. Grounding our argument in principles of Community Psychology and positive youth development, we outline how the presence and actions of SBLE negatively affect individual students as well as school systems, with particularly harmful outcomes for students with minoritized and marginalized identities. Research on SBLE and school crime does not provide consistent evidence of positive impacts, and many studies find null effects for the relationship between SBLE and school crime or increases in crime and violence in schools. Though funding for SBLE is often prompted by high-profile acts of gun violence in schools, evidence suggests that SBLE neither prevents these incidents, nor lessens the severity when they do occur. Thus, we advocate for removing law enforcement from school settings and redirecting resources into inclusive, evidence-informed responses that are generally safer and more effective than SBLE. We close by outlining the policy landscape governing SBLE programs and ways communities can lobby for change

Aggregate risk of cardiovascular disease among adolescents perinatally infected with the human immunodeficiency virus

BACKGROUND: Perinatally HIV-infected adolescents may be susceptible to aggregate atherosclerotic cardiovascular disease risk, as measured by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary arteries and abdominal aorta risk scores, as a result of prolonged exposure to HIV and antiretroviral therapy. METHODS AND RESULTS: Coronary arteries and abdominal aorta PDAY scores were calculated for 165 perinatally HIV-infected adolescents, using a weighted combination of modifiable risk factors: dyslipidemia, cigarette smoking, hypertension, obesity, and hyperglycemia. Demographic and HIV-specific predictors of scores ≥1 were identified, and trends in scores over time were assessed. Forty-eight percent and 24% of the perinatally HIV-infected adolescents had coronary arteries and abdominal aorta scores ≥1, representing increased cardiovascular disease risk factor burden. Significant predictors of coronary arteries scores ≥1 included male sex, history of an AIDS-defining condition, longer duration of use of a ritonavir-boosted protease inhibitor, and no prior use of tenofovir. Significant predictors of abdominal aorta scores ≥1 included suppressed viral load, history of an AIDS-defining condition, and longer duration of boosted protease inhibitor use. No significant changes in coronary arteries and abdominal aorta risk scores were observed over the 4-year study period. CONCLUSIONS: A substantial proportion of perinatally HIV-infected youth have high PDAY scores, reflecting increased aggregate atherosclerotic cardiovascular disease risk factor burden. High scores were predicted by HIV disease severity and boosted protease inhibitor use. PDAY scores may be useful in identifying high-risk youth who may benefit from early lifestyle or clinical interventions

Role of Adjuvant Multimodality Therapy After Curative-Intent Resection of Ampullary Carcinoma

Importance: Ampullary adenocarcinoma is a rare malignant neoplasm that arises within the duodenal ampullary complex. The role of adjuvant therapy (AT) in the treatment of ampullary adenocarcinoma has not been clearly defined. Objective: To determine if long-term survival after curative-intent resection of ampullary adenocarcinoma may be improved by selection of patients for AT directed by histologic subtype. Design, setting, and participants: This multinational, retrospective cohort study was conducted at 12 institutions from April 1, 2000, to July 31, 2017, among 357 patients with resected, nonmetastatic ampullary adenocarcinoma receiving surgery alone or AT. Cox proportional hazards regression was used to identify covariates associated with overall survival. The surgery alone and AT cohorts were matched 1:1 by propensity scores based on the likelihood of receiving AT or by survival hazard from Cox modeling. Overall survival was compared with Kaplan-Meier estimates. Exposures: Adjuvant chemotherapy (fluorouracil- or gemcitabine-based) with or without radiotherapy. Main outcomes and measures: Overall survival. Results: A total of 357 patients (156 women and 201 men; median age, 65.8 years [interquartile range, 58-74 years]) underwent curative-intent resection of ampullary adenocarcinoma. Patients with intestinal subtype had a longer median overall survival compared with those with pancreatobiliary subtype (77 vs 54 months; P = .05). Histologic subtype was not associated with AT administration (intestinal, 52.9% [101 of 191]; and pancreatobiliary, 59.5% [78 of 131]; P = .24). Patients with pancreatobiliary histologic subtype most commonly received gemcitabine-based regimens (71.0% [22 of 31]) or combinations of gemcitabine and fluorouracil (12.9% [4 of 31]), whereas treatment of those with intestinal histologic subtype was more varied (fluorouracil, 50.0% [17 of 34]; gemcitabine, 44.1% [15 of 34]; P = .01). In the propensity score-matched cohort, AT was not associated with a survival benefit for either histologic subtype (intestinal: hazard ratio, 1.21; 95% CI, 0.67-2.16; P = .53; pancreatobiliary: hazard ratio, 1.35; 95% CI, 0.66-2.76; P = .41). Conclusions and relevance: Adjuvant therapy was more frequently used in patients with poor prognostic factors but was not associated with demonstrable improvements in survival, regardless of tumor histologic subtype. The value of a multimodality regimen remains poorly defined