Physical activity among adults with diabetes mellitus in Rwanda

Diabetes mellitus is one of the most common non-communicable diseases, and is the fifth leading cause of death in most developing countries. Regular physical activity is strongly recommended for individuals with diabetes for its beneficial effects in the improvement of blood glucose control and insulin sensitivity, prevention and reduction of morbidities and complications, as well as for its cardiovascular benefits. Using a cross-sectional design, this study examined the demographic, social and health-related factors associated with physical activity participation among adults with diabetes mellitus in Kigali, Rwanda. One hundred-and-fifty six (156) adults with diabetes mellitus participated in the study. More than a third (39%) of the participants was categorized as inactive. Active participants were significantly younger than those categorized as inactive. Age, marital status, level of education and self-efficacy for diabetes were all significantly associated with levels of physical activity. Common barriers to participation in physical activity were cited as poor health status, lack of motivation and lack of awareness about the importance of physical activity. It is thus clear that efforts should be made to educate adults with diabetes mellitus about the benefits of integrating regular physical activity in their daily routine.Department of HE and Training approved lis

Vocational rehabilitation following traumatic brain injury: what is the evidence for clinical practice?

Traumatic brain injury (TBI) typically affects young adults with potentially many years of working life ahead of them. For people who were in work prior to their injury, return to work (RTW) is a common goal. However, a systematic review of RTW rates for people with TBI who were in work prior to their injury found that approximately 41% were in work at one and two years post TBI [1]. Since TBI is a leading cause of morbidity worldwide in young adults [2], this discrepancy between what people with TBI want and what they achieve is important. The question is does the research evidence inform clinicians how to help a person with TBI return to work

A First Exposure to Statistical Mechanics for Life Scientists

Statistical mechanics is one of the most powerful and elegant tools in the quantitative sciences. One key virtue of statistical mechanics is that it is designed to examine large systems with many interacting degrees of freedom, providing a clue that it might have some bearing on the analysis of the molecules of living matter. As a result of data on biological systems becoming increasingly quantitative, there is a concomitant demand that the models set forth to describe biological systems be themselves quantitative. We describe how statistical mechanics is part of the quantitative toolkit that is needed to respond to such data. The power of statistical mechanics is not limited to traditional physical and chemical problems and there are a host of interesting ways in which these ideas can be applied in biology. This article reports on our efforts to teach statistical mechanics to life science students and provides a framework for others interested in bringing these tools to a nontraditional audience in the life sciences.Comment: 27 pages, 16 figures. Submitted to American Journal of Physic

Changes in structural network topology correlate with severity of hallucinatory behavior in Parkinson's disease

Inefficient integration between bottom-up visual input and higher order visual processing regions is implicated in visual hallucinations in Parkinson's disease (PD). Here, we investigated white matter contributions to this perceptual imbalance hypothesis. Twenty-nine PD patients were assessed for hallucinatory behavior. Hallucination severity was correlated to connectivity strength of the network using the network-based statistic approach. The results showed that hallucination severity was associated with reduced connectivity within a subnetwork that included the majority of the diverse club. This network showed overall greater between-module scores compared with nodes not associated with hallucination severity. Reduced between-module connectivity in the lateral occipital cortex, insula, and pars orbitalis and decreased within-module connectivity in the prefrontal, somatosensory, and primary visual cortices were associated with hallucination severity. Conversely, hallucination severity was associated with increased between- and within-module connectivity in the orbitofrontal and temporal cortex, as well as regions comprising the dorsal attentional and default mode network. These results suggest that hallucination severity is associated with marked alterations in structural network topology with changes in participation along the perceptual hierarchy. This may result in the inefficient transfer of information that gives rise to hallucinations in PD. Author SummaryInefficient integration of information between external stimuli and internal perceptual predictions may lead to misperceptions or visual hallucinations in Parkinson's disease (PD). In this study, we show that hallucinatory behavior in PD patients is associated with marked alterations in structural network topology. Severity of hallucinatory behavior was associated with decreased connectivity in a large subnetwork that included the majority of the diverse club, nodes with a high number of between-module connections. Furthermore, changes in between-module connectivity were found across brain regions involved in visual processing, top-down prediction centers, and endogenous attention, including the occipital, orbitofrontal, and posterior cingulate cortex. Together, these findings suggest that impaired integration across different sides across different perceptual processing regions may result in inefficient transfer of information

Traumatic spinal cord injury in South Africa and Sweden : epidemiologic features and functioning

Background: Trauma to the human spinal cord typically strikes out of the blue, leaving those surviving the initial ordeal with permanent or temporary deficits in health and functioning. Because of this, traumatic spinal cord injuries (TSCI) impose a significant burden on society. While these facts are well known for certain countries, the International Perspectives on Spinal Cord Injury Report highlights the need for the remaining countries to establish a foundation upon which injuries could be prevented and functioning problems addressed. In South Africa, the foundation for primary prevention and knowledge of the unmet needs of persons with TSCI are not yet established. Aim: To develop an evidence-based foundation for TSCI in South Africa that addresses prevention both in terms of injury occurrence and problems with functioning. Methods: This thesis utilised a mixed-method approach to answer epidemiologic and functioning questions. A prospective, population-based design was used in Study I and II to determine the incidence, aetiology and injury profiles of newly-injured adults with TSCI in Cape Town, South Africa and Stockholm, Sweden. In the Functioning section of the thesis (Study III), a comparative content validity design was used to define the nature of functioning categories in a generic outcome measure currently used in the South African SCI rehabilitation field, and a standardised measure not yet adopted in the local context, against the International Classification of Functioning, Disability and Health and the brief ICF core sets for SCI in the post-acute context. In Study IV, qualitative description was used to explore the experiences of reclaiming participation in 17 chronic survivors of TSCI by emphasising their met and unmet needs as well as the conditions influencing them. Findings: One-hundred and forty-seven and 49 incident cases, resulting in an annual crude incidence rate of 75.6 and 19.0 per million population, were registered for the region of South Africa (study I) and Sweden (study II), respectively. The leading cause of injury in South Africa was assault, accounting for approximately 60% of all incident cases, compared with the leading cause in Sweden, where falls was responsible for 58% of all cases. The two cohorts differed significantly with respect to demographic and aetiologic characteristics. Concerning functioning, Study III found that the generic rehabilitation outcome measure was not fully conceptualised within the ICF and did not cover all the essential functioning aspects as contained in the brief core set. In contrast, the standardised outcome measure was fully conceptualised within the ICF and covered, in its entirety, the activity and participation categories contained in the brief core set. In Study IV, clients’ perspectives confirmed 'participation' as a desirable and possible goal by effectively dealing with the new self, negotiating obstacles, identifying facilitators of participation, and becoming an agent. These critical aspects − also categories − were essential for reconstructing meaning and prioritising important life situations. Conclusions: The incidence of TSCI in South Africa is among the highest in the world and is mainly caused by assault, while the incidence in Sweden appeared consistent to what is proposed for Western Europe. Furthermore, there is a need to raise awareness and facilitate the use of standardised outcome measures in TSCI rehabilitation, since the current operational measure in the South African SCI rehabilitation field presented some shortcomings. It is remarkable to conclude that while participation is indeed a reality after injury, the dimensionality of challenges remains an issue for further discourse. The insights gained from these studies provide an evidence-based foundation for impacting primary prevention action plans and the alignment of rehabilitation practices towards addressing the unmet needs of survivors

Economic Perspectives on Personalized Health Care and Prevention

The objective of this paper is to provide an overview of economic evaluation of personalized medicine, focusing particularly on the use of cost-effectiveness analysis and other methods of valuation. We draw on insights from the literature and our work at the University of California, San Francisco Center for Translational and Policy Research on Personalized Medicine (TRANSPERS). We begin with a discussion of why personalized medicine is of interest and challenges to adoption, whether personalized medicine is different enough to require different evaluation approaches, and what is known about the economics of personalized medicine. We then discuss insights from TRANSPERS research and six areas for future research

The role of social attention in older adults’ ability to interpret naturalistic social scenes

Funding This work was supported by a Discovery Project grant (DP150100302) from the Australian Research Council awarded to J.D.H. and L.H.P.Peer reviewedPostprin

A First Exposure to Statistical Mechanics for Life Scientists: Applications to Binding

Statistical mechanics is one of the most powerful and elegant tools in the quantitative sciences. One key virtue of statistical mechanics is that it is designed to examine large systems with many interacting degrees of freedom, providing a clue that it might have some bearing on the analysis of the molecules of living matter. As a result of data on biological systems becoming increasingly quantitative, there is a concomitant demand that the models set forth to describe biological systems be themselves quantitative. We describe how statistical mechanics is part of the quantitative toolkit that is needed to respond to such data. The power of statistical mechanics is not limited to traditional physical and chemical problems and there are a host of interesting ways in which these ideas can be applied in biology. This article reports on our efforts to teach statistical mechanics to life science students with special reference to binding problems in biology and provides a framework for others interested in bringing these tools to a nontraditional audience in the life sciences. 1 1 Does Statistical Mechanics Matter in Biology

Age Deficits in Facial Affect Recognition : The Influence of Dynamic Cues

Funding This work was supported by the Australian Research Council, Australia (DP150100302) and the Leverhulme Trust, U.K. (F/00152/W).Peer reviewedPostprin