Heel raises versus prefabricated orthoses in the treatment of posterior heel pain associated with calcaneal apophysitis (Sever's Disease): study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Posterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever's disease. This study seeks to compare the clinical efficacy of some currently employed treatment options for the relief of disability and pain associated with posterior heel pain in children.</p> <p>Method</p> <p>Design: Factorial 2 × 2 randomised controlled trial with monthly follow-up for 3 months.</p> <p>Participants: Children with clinically diagnosed posterior heel pain possibly associated with calcaneal apophysitis/Sever's disease (n = 124).</p> <p>Interventions: Treatment factor 1 will be two types of shoe orthoses: a heel raise or prefabricated orthoses. Both of these interventions are widely available, mutually exclusive treatment approaches that are relatively low in cost. Treatment factor 2 will be a footwear prescription/replacement intervention involving a shoe with a firm heel counter, dual density EVA midsole and rear foot control. The alternate condition in this factor is no footwear prescription/replacement, with the participant wearing their current footwear.</p> <p>Outcomes: Oxford Foot and Ankle Questionnaire and the Faces pain scale.</p> <p>Discussion</p> <p>This will be a randomised trial to compare the efficacy of various treatment options for posterior heel pain in children that may be associated with calcaneal apophysitis also known as Sever's disease.</p> <p>Trial Registration</p> <p>Trial Number: ACTRN12609000696291</p> <p>Ethics Approval Southern Health: HREC Ref: 09271B</p

Relationship between functional fitness, medication costs and mood in elderly people

Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt

Immunolocalization of cell wall polymers in grapevine (Vitis vinifera) internodes under nitrogen, phosphorus or sulfur deficiency

Abstract The impact on cell wall (CW) of the deficiency in nitrogen (–N), phosphorus (–P) or sulphur (–S), known to impair essential metabolic pathways, was investigated in the economically important fruit species Vitis vinifera L. Using cuttings as an experimental model a reduction in total internode number and altered xylem shape was observed. Under –N an increased internode length was also seen. CW composition, visualised after staining with calcofluor white, Toluidine blue and ruthenium red, showed decreased cellulose in all stresses and increased pectin content in recently formed internodes under –N compared to the control. Using CW-epitope specific monoclonal antibodies (mAbs), lower amounts of extensins incorporated in the wall were also observed under –N and –P conditions. Conversely, increased pectins with a low degree of methyl-esterification and richer in long linear 1,5-arabinan rhamnogalacturonan-I (RG-I) side chains were observed under –N and –P in mature internodes which, in the former condition, were able to form dimeric association through calcium ions. –N was the only condition in which 1,5-arabinan branched RG- content was not altered, as –P and –S older internodes showed, respectively, lower and higher amounts of this polymer. Higher xyloglucan content in older internodes was also observed under –N. The results suggest that impairments of specific CW components led to changes in the deposition of other polymers to promote stiffening of the CW. The unchanged extensin amount observed under –S may contribute to attenuating the effects on the CW integrity caused by this stress. Our work showed that, in organized V. vinifera tissues, modifications in a given CW component can be compensated by synthesis of different polymers and/or alternative linking between polymers. The results also pinpoint different strategies at the CW level to overcome mineral stress depending on how essential they are to cell growth and plant development

Internal Marketing Orientation: an empirical research in hotel sector

The study has three aims. First, to measure internal market orientation second, to analyze the relation-ships between IMO and two organizational consequences: job satisfaction and commitment; and third,to incorporate a new sub-dimension work/family balance. Empirical research has been done in a sampleof Spanish hotels. Results show that IMO is a strategic determinant of both job satisfaction and employeecommitment

Identidad, territorio y promocion de la salud

El presente trabajo se enmarca dentro de un proyecto de extensión que se desarrolla durante el 2012, acreditado y financiado por la UNLP, denominado “Identidad, territorio y salud. Construcción de identidades colectivas y transferencia institucional en torno al primer nivel de atención en el Barrio Federal de Ensenada”. Este barrio cuenta con una población aproximada de 480 habitantes y está ubicado en la zona de Gran La Plata, Pcia. de Buenos Aires. El objetivo del trabajo consiste en fortalecer la apropiación y promoción de la salud colectiva, entendida ésta como un proceso construido históricamente por cada sociedad, que se crea y recrea en todos los aspectos de la vida cotidiana de los sujetos. La propuesta metodológica se sustenta en un proceso dialógico entre los sujetos involucrados: vecinos de barrio Federal y los integrantes del equipo del trabajo extensionista. Desde este marco (pedagógico horizontal) desarrollamos actividades grupales de carácter lúdico-recreativo, que a primera vista no aparentan tener una relación con el proceso salud-enfermedad, propio del imaginario social, pero implícitamente, estarían abarcando y generando cambios en el significado asignado del mismo. Partimos de la idea de fortalecer el sentirse bien, no en el estricto sentido biológico, sino como aquella capacidad para crear momentos y actividades con pares en un mismo territorio y generando lazos entre vecinos y entre éstos y la institución de salud del barrio. De este modo, las actividades se desarrollan principalmente en la sala de espera de la unidad sanitaria y en la plaza circundante. Hemos definido tres líneas de trabajo: artístico, narrativo-plástico y de producción audiovisual y medioambiente. En los encuentros se trabaja con diferentes recursos, propios de disciplinas como música, plástica, teatro, danza, escultura, circo, artes audiovisuales, literatura, entre otros. El carácter interdisciplinario de este proyecto, conformado por estudiantes de las carreras de Trabajo Social y Antropología, un artista escultor y dirigido y coordinado por docentes y graduados de las Facultades de Ciencias Medicas, Humanidades y Ciencias de la Educación y Trabajo Social, enriquece las perspectivas de abordaje y fortalece la visión social, integral y colectiva de la salud. Consolidar acciones identitarias del barrio, generadas a partir de la promoción de la salud, es el principal desafío a alcanzar

Large scale multifactorial likelihood quantitative analysis of BRCA1 and BRCA2 variants: An ENIGMA resource to support clinical variant classification

The multifactorial likelihood analysis method has demonstrated utility for quantitative assessment of variant pathogenicity for multiple cancer syndrome genes. Independent data types currently incorporated in the model for assessing BRCA1 and BRCA2 variants include clinically calibrated prior probability of pathogenicity based on variant location and bioinformatic prediction of variant effect, co-segregation, family cancer history profile, co-occurrence with a pathogenic variant in the same gene, breast tumor pathology, and case-control information. Research and clinical data for multifactorial likelihood analysis were collated for 1,395 BRCA1/2 predominantly intronic and missense variants, enabling classification based on posterior probability of pathogenicity for 734 variants: 447 variants were classified as (likely) benign, and 94 as (likely) pathogenic; and 248 classifications were new or considerably altered relative to ClinVar submissions. Classifications were compared with information not yet included in the likelihood model, and evidence strengths aligned to those recommended for ACMG/AMP classification codes. Altered mRNA splicing or function relative to known nonpathogenic variant controls were moderately to strongly predictive of variant pathogenicity. Variant absence in population datasets provided supporting evidence for variant pathogenicity. These findings have direct relevance for BRCA1 and BRCA2 variant evaluation, and justify the need for gene-specific calibration of evidence types used for variant classification