The Impact of Walker Style on Gait Characteristics in Non-assistive Device Dependent older Adults

BACKGROUND AND PURPOSE: Approximately 24% of adults over the age of 65 have reported using an assistive device (AD), and this number is expected to rise in the next 25 years as the population ages. Although ADs are used to improve balance and increase independence, the impact of ADs on gait characteristics needs further exploration due to limited literature. The purpose of this study was to compare the impact of different ADs on gait speed, stride length, double limb support, and pelvic rotation in non-AD dependent, community-dwelling older adults. The results could prove useful in guiding clinical decision making when prescribing an AD to older adults. METHODS: Twenty-eight subjects (x̅=69.5, range 55-92 years old) completed the study, with six subjects being male. The BTS G-Walk, a tri-axial accelerometer, was used to measure gait characteristics during four separate conditions: walking without an AD, using a two wheeled walker (2WW), using a four wheeled walker (4WW), and using a novel device known as the Gaiter. Subjects completed three trials of each condition in random order along a 100 foot walkway. A one-way ANOVA was used to analyze data for differences in gait speed, stride length, double limb support, and pelvic rotation between conditions. RESULTS: The results of the one-way ANOVA showed a significant difference in double limb support (p=0.025). No significant differences were noted in stride length (p=0.191), gait speed (p = 0.092), or pelvic rotation (p= 0.47). However, gait speed approached significance when any AD was used. Gait speed was slowest with 2WW and 4WW (x̅=1.15 m/s). A post-hoc analysis revealed an increase in double limb support when subjects ambulated with a 4WW compared to no AD (p=0.03). CONCLUSION: These results suggest that walker style does not significantly impact most gait characteristics in older individuals that are not dependent on an AD. The variable most impacted was double limb support, which is consistent with current literature. Increased double limb support has been shown to decrease gait speed and increase risk of falls. This study holds clinical significance in that the prescription of a walker in non-AD dependent older adults has the potential to negatively impact gait

Asset Mapping and Focus Group Usage: An Exploration of the Russian-Ukrainian Population’s Need For and Use of Health-Related Community Resources

Community resources are an important aspect of preventive medicine and can also provide support to individuals with existing medical conditions. However, resources may not address all population groups within the community equally, and immigrants, who frequently face cultural and language barriers, are often unable to access the full range of healthcare resources available in the community. The purpose of this study was to gain insight on healthcare needs, attitudes, and access of a Ukrainian immigrant population in a large town in northern Indiana. Focus groups were conducted as a first step to creating connections upon which a community-based participatory research project could be built. Findings revealed cultural barriers (lack of understanding of health insurance options or value, belief that similar services were less expensive in the Ukraine) and language issues (lack of translation services or resources written in languages other than English or Spanish) were key barriers to accessing healthcare resources in the community. Concerns about dental care and its expense were also voiced. Future efforts might build on these findings by exploring policies and practices that affect various immigrant groups’ access to community healthcare resources. Recommendations for such efforts are also discussed

Bimodal function of chromatin remodeler Hmga1 in neural crest induction and Wnt-dependent emigration

During gastrulation, neural crest cells are specified at the neural plate border, as characterized by Pax7 expression. Using single-cell RNA sequencing coupled with high resolution in situ hybridization to identify novel transcriptional regulators, we show that chromatin remodeler Hmga1 is highly expressed prior to specification and maintained in migrating chick neural crest cells. Temporally-controlled CRISPR-Cas9-mediated knockouts uncovered two distinct functions of Hmga1 in neural crest development. At the neural plate border, Hmga1 regulates Pax7-dependent neural crest lineage specification. At premigratory stages, a second role manifests where Hmga1 loss reduces cranial crest emigration from the dorsal neural tube independent of Pax7. Interestingly, this is rescued by stabilized ß-catenin, thus implicating Hmga1 as a canonical Wnt activator. Together, our results show that Hmga1 functions in a bimodal manner during neural crest development to regulate specification at the neural plate border, and subsequent emigration from the neural tube via canonical Wnt signaling

Mapping eutrophication risk from climate change: future phosphorus concentrations in English rivers

Climate change is expected to increase eutrophication risk in rivers yet few studies identify the timescale or spatial extent of such impacts. Phosphorus concentration, considered the primary driver of eutrophication risk in English rivers, may increase through reduced dilution particularly if river flows are lower in summer. Detailed models can indicate change in catchment phosphorus concentrations but targeted support for mitigation measures requires a national scale evaluation of risk. In this study, a load apportionment model is used to describe the current relationship between flow and total reactive phosphorus (TRP) at 115 river sites across England. These relationships are used to estimate TRP concentrations for the 2050s under 11 climate change driven scenarios of future river flows and under scenarios of both current and higher levels of sewage treatment. National maps of change indicate a small but inconsistent increase in annual average TRP concentrations with a greater change in summer. Reducing the TRP concentration of final sewage effluent to 0.5 mg/L P for all upstream sewage treatment works was inadequate to meet existing P standards required through the EU Water Framework Directive, indicating that more needs to be done, including efforts to reduce diffuse pollution

Money Follows the Person: Transitioning Nursing Home Residents into the Community

Introduction. Research has shown that admission to nursing homes (NH) is associated with decline in several measures of well-being; transitioning out of a NH into the community is a positive predictor for quality of life. Currently, the State of Vermont offers several housing options for Medicaid eligible NH residents; however, there are very few opportunities to fully integrate into the communityhttps://scholarworks.uvm.edu/comphp_gallery/1090/thumbnail.jp

Irreversibly increased nitrogen fixation in Trichodesmium experimentally adapted to elevated carbon dioxide

This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Nature Communications 6 (2015): 8155, doi:10.1038/ncomms9155.Nitrogen fixation rates of the globally distributed, biogeochemically important marine cyanobacterium Trichodesmium increase under high carbon dioxide (CO2) levels in short-term studies due to physiological plasticity. However, its long-term adaptive responses to ongoing anthropogenic CO2 increases are unknown. Here we show that experimental evolution under extended selection at projected future elevated CO2 levels results in irreversible, large increases in nitrogen fixation and growth rates, even after being moved back to lower present day CO2 levels for hundreds of generations. This represents an unprecedented microbial evolutionary response, as reproductive fitness increases acquired in the selection environment are maintained after returning to the ancestral environment. Constitutive rate increases are accompanied by irreversible shifts in diel nitrogen fixation patterns, and increased activity of a potentially regulatory DNA methyltransferase enzyme. High CO2-selected cell lines also exhibit increased phosphorus-limited growth rates, suggesting a potential advantage for this keystone organism in a more nutrient-limited, acidified future ocean.Grant support was provided by U.S. National Science Foundation OCE 1260490 and OCE 1143760 to D.A.H., E.A.W., and F.-X.F, and OCE 1260233, OCE OA 1220484, and G.B. Moore Foundation 3782 and 3934 to M.A.S.© The Author(s), [year]

Mechanisms of increased Trichodesmium fitness under iron and phosphorus co-limitation in the present and future ocean

© The Author(s), 2016. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Nature Communications 7 (2016): 12081, doi:10.1038/ncomms12081.Nitrogen fixation by cyanobacteria supplies critical bioavailable nitrogen to marine ecosystems worldwide; however, field and lab data have demonstrated it to be limited by iron, phosphorus and/or CO2. To address unknown future interactions among these factors, we grew the nitrogen-fixing cyanobacterium Trichodesmium for 1 year under Fe/P co-limitation following 7 years of both low and high CO2 selection. Fe/P co-limited cell lines demonstrated a complex cellular response including increased growth rates, broad proteome restructuring and cell size reductions relative to steady-state growth limited by either Fe or P alone. Fe/P co-limitation increased abundance of a protein containing a conserved domain previously implicated in cell size regulation, suggesting a similar role in Trichodesmium. Increased CO2 further induced nutrient-limited proteome shifts in widespread core metabolisms. Our results thus suggest that N2-fixing microbes may be significantly impacted by interactions between elevated CO2 and nutrient limitation, with broad implications for global biogeochemical cycles in the future ocean.Grant support was provided by U.S. National Science Foundation OCE 1260490 to D.A.H., E.A.W. and F.-X.F., and OCE OA 1220484 and G.B. Moore Foundation 3782 and 3934 to M.A.S

Bromoform-assisted aqueous free radical polymerisation: a simple, inexpensive route for the preparation of block copolymers

In the quest for commercially relevant block copolymer additives, for which overall average molecular composition is key but molar mass distribution is of little importance, we present a straightforward, sulfur- and metal-free aqueous route to block copolymers using commercially available starting materials. Based on synthetic techniques first described in the 1950s for hydrophobic monomers in organic solvents, we have shown that bromoform (CHBr3) can be used to create block copolymers. Unlike common bromine-containing chain transfer agents such as carbon tetrabromide (CBr4), bromoform is partially water-miscible and relatively inexpensive. Herein, we demonstrate this new aqueous-based technology using N,N-dimethylacrylamide (DMA) and N-isopropylacrylamide (NIPAM) as exemplar monomers to synthesise PDMA-b-PNIPAM block copolymers of varying composition directly in water. This study demonstrates the potential for such a simple, inexpensive route to functional block copolymers where further research to decipher the detailed mechanism and true potential of this technique will be of great value