Gait characteristics of subjects with chronic fatigue syndrome and controls at self-selected and matched velocities

Background: Gait abnormalities have been reported in individuals with Chronic Fatigue Syndrome (CFS) however no studies exist to date investigating the kinematics of individuals with CFS in over-ground gait. The aim of this study was to compare the over-ground gait pattern (sagittal kinematics and temporal and spatial) of individuals with CFS and control subjects at their self-selected and at matched velocities. Methods: Twelve individuals with CFS and 12 matched controls participated in the study. Each subject walked along a 7.2 m walkway three times at each of three velocities: self-selected, relatively slow (0.45 ms-1) and a relatively fast (1.34 ms-1). A motion analysis system was used to investigate the sagittal plane joint kinematics and temporal spatial parameters of gait. Results: At self-selected velocity there were significant differences between the two groups for all the temporal and spatial parameters measured, including gait velocity (P = 0.002). For the kinematic variables the significant differences were related to both ankles during swing and the right ankle during stance. At the relatively slower velocity the kinematic differences were replicated. However, the step distances decreased in the CFS population for the temporal and spatial parameters. When the gait pattern of the individuals with CFS at the relatively fast walking velocity (1.30 ± 0.24 ms-1) was compared to the control subjects at their self-selected velocity (1.32 ± 0.15 ms-1) the gait pattern of the two groups was very similar, with the exception of both ankles during swing. Conclusion: The self-selected gait velocity and/or pattern of individuals with CFS may be used to monitor the disease process or evaluate therapeutic intervention. These differences may be a reflection of the relatively low self-selected gait velocity of individuals with CFS rather than a manifestation of the condition itself

Commercial hospitality : a vehicle for the sustainable empowerment of Nepali women

To illustrate how commercial hospitality has catalysed sustainable social change in Nepal through empowering women. Utilising a new framework, developed by combining existing theories, empowerment of women Tea House owners/ managers is assessed. Within a critical feminist paradigm, primary research consisting of interviews and participant observation was undertaken in Nepal over a three month period in the central region of Nepal. Involvement in the hospitality industry improved the livelihoods of the women Tea House owners/ managers, it also has the potential to facilitate sustainable empowerment for future generations, providing them with education, choice, control and opportunities. Although steps were taken to limit rhetorical issues, language barriers could have influenced the findings of the interviews. To fully investigate the potential for hospitality to act as a vehicle for the sustainable empowerment of women, it is suggested that this study be replicated again in another region or that a detailed ethnographic study be carried out. Demonstrates how the commercial hospitality industry can be a force for good; women working in the industry are agents of change, actively improving their levels of empowerment in their immediate environment. The commercial hospitality industry has pioneered the empowerment of women and this could lay the foundation for the further emancipation of women. To date, there has been limited research into the relationship between involvement in the commercial hospitality sector and the empowerment of women; this paper begins to fill this gap by investigating a tourist region of Nepal

Mutuality in Movement: A Relational Approach to Dance/Movement Therapy With Domestic Violence Survivors

This qualitative case study explored the integration of relational-cultural therapy and dance/movement therapy (DMT), or relational-DMT, with survivors of domestic violence. The study examined how participants experience relational-DMT and the therapeutic relationship we established together. Three culturally diverse participants receiving individual short-term counseling services at a domestic violence service agency were included in the study. Three forms of data were collected over six to eight therapy sessions. Following each session, the participants completed the Helpful Aspects of Therapy questionnaire, while the researcher completed embodied case documentation (Fogel, 2007). After the final therapy session, a semi-structured interview was conducted with each participant to explore themes emerging from the data. Data were analyzed within-case and across-cases using Forinash’s (2004) qualitative data analysis method. Data illustrated how these embodied therapeutic relationships became places of feeling deeply understood, where movement brought participants into vulnerable material in a manner that felt safe and which facilitated trust. In this way, movement experiences played a significant role in the development of these growth-fostering relationships by providing an inroad to authentic connection. 138 pages

Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: a systematic review

Background nurse shortages have been identified as central to workforce issues in healthcare systems globally and although interventions to increase the nursing workforce have been implemented, nurses leaving their roles, particularly in the first year after qualification, present a significant barrier to building the nurse workforce. Objective to evaluate the characteristics of successful interventions to promote retention and reduce turnover of early career nurses. Design this is a systematic review Data sources Online databases including Academic Search Complete, Medline, Health Policy reference Centre, EMBASE, Psychinfo, CINAHL and the Cochran Library were searched to identify relevant publications in English published between 2001 and April 2018. Studies included evaluated an intervention to increase retention or reduce turnover and used turnover or retention figures as a measure. Review methods The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were quality-assessed using the Joanna Briggs Institute Critical Appraisal tools for Quasi Experimental and Randomised Controlled Trials. Retention/turnover data were used to guide the comparison between studies and appropriate measures of central tendency and dispersion were calculated and presented, based on the normality of the data. Results A total of 11, 656 papers were identified, of which 53 were eligible studies. A wide variety of interventions and components within those interventions were identified to improve nurse retention. Promising interventions appear to be either internship/residency programmes or orientation/transition to practice programmes, lasting between 27-52 weeks, with a teaching and preceptor and mentor component. Conclusions Methodological issues impacted on the extent to which conclusions could be drawn, even though a large number of studies were identified. Future research should focus on standardising the reporting of interventions and outcome measures used to evaluate these interventions and carrying out further research with rigorous methodology. Clinical practice areas are recommended to assess their current interventions against the identified criteria to guide development of their effectiveness. Evaluations of cost-effectiveness are considered an important next step to maximise return on investment

Maghemite-like regions at crossing of two antiphase boundaries in doped BiFeO3

We report the observation of a novel structure at the point where two antiphase boundaries cross in a doped bismuth ferrite of composition (Bi0.85Nd0.15)(Fe0.9Ti0.1)O0.3. The structure was investigated using a combination of high angle annular dark field imaging and electron energy loss spectroscopy spectrum imaging in the scanning transmission electron microscope. A three-dimensional model was constructed by combining the position and chemistry data with previous results and assuming octahedral coordination of all Fe and Ti atoms. The resulting structure shows some novel L shaped arrangements of iron columns, which are coordinated in a similar manner to FeO6 octahedra in maghemite. It is suggested that this may lead to local ferromagnetic orderings similar to those in maghemite

Breaking Down the Barriers to Pediatric Procedural Preparation

There are characteristics of children’s medical pain that makes it amenable to intervention. Specifically, almost all procedural events are planned and the steps of the procedure are scripted. Thus, the parent and patient have the ability to be well prepared to handle the stressor. In fact, the medical situation could even be viewed as a valuable opportunity for the family to learn and practice coping skills, which in turn can result in a heightened sense of mastery and empowerment for future expected and unexpected pain and suffering in life. The preparation literature is sufficiently strong to allow recommendations regarding how to prepare children, when to prepare children, and what individual characteristics to consider when preparing children for upcoming painful procedures. Unfortunately, there are considerable obstacles that are preventing this important advice from being put into practice. To take the next critical step of moving the evidence-based advice into the medical setting, it is vital to identify barriers to this translation and to work at removing or working around them. Below, we consider some of the barriers to implementing pediatric procedural preparation. In addition, we offer potential solutions while recognizing that this is no easy task, for, if it were, the barriers would have long been overcome. That said, solutions are posited in hopes that they might inspire others to think of novel answers to incorporating good pediatric preparation science into our medical settings

Long-term visual and microperimetry outcomes following autologous retinal pigment epithelium choroid graft for neovascular age-related macular degeneration

To describe the 2- to 4-year visual and microperimetry outcomes of autologous retinal pigment epithelium (RPE)-choroid graft in patients with neovascular age-related macular degeneration (AMD).In this retrospective cohort study, 12 patients with subfoveal neovascular AMD who had undergone autologous RPE-choroid graft between August 2004 and June 2005 were reviewed. Change in visual acuity (VA), contrast sensitivity (CS), fixation stability and retinal sensitivity on microperimetry after 2-3 years and the rates of late postoperative complications were examined.Patients were followed for 26-48 months (mean, 39). Median preoperative VA (logMAR) was 0.87 but declined to 1.43 (1 year), 1.46 (2 years) and 1.38 (3 years), P = 0.001. Median CS (logCS) was 0.75 preoperatively but declined to 0.45 at 2 years. Six patients had serial microperimetry. Fixation stability declined in 1 but improved in 2 patients. All 6 had decline in retinal sensitivity over the graft during follow up. Retinal detachment did not occur after 12 months but 8 developed epiretinal membrane, 12 had cystic retinal change over the graft and 4 developed recurrent choroidal neovascularization. However, 10 grafts retained autofluorescence signal at 18-48 months of follow up.Autologous RPE-choroid graft can maintain VA, stable fixation and retinal sensitivity in some patients for over 3 years. The spatial correlation between graft autofluorescence, outer retinal structures on optical coherence tomography and retinal sensitivity are consistent with photoreceptor cell rescue. However, we caution the use of this technique as there is high complication rate and delayed loss of retinal function

Origins of ferromagnetism in transition-metal doped Si

We present results of the magnetic, structural and chemical characterizations of Mn<sup>+</sup>-implanted Si displaying <i>n</i>-type semiconducting behavior and ferromagnetic ordering with Curie temperature,T<sub>C</sub> well above room temperature. The temperature-dependent magnetization measured by superconducting quantum device interference (SQUID) from 5 K to 800 K was characterized by three different critical temperatures (T*<sub>C</sub>~45 K, T<sub>C1</sub>~630-650 K and T<sub>C2</sub>~805-825 K). Their origins were investigated using dynamic secondary mass ion spectroscopy (SIMS) and transmission electron microscopy (TEM) techniques, including electron energy loss spectroscopy (EELS), Z-contrast STEM (scanning TEM) imaging and electron diffraction. We provided direct evidences of the presence of a small amount of Fe and Cr impurities which were unintentionally doped into the samples together with the Mn<sup>+</sup> ions, as well as the formation of Mn-rich precipitates embedded in a Mn-poor matrix. The observed T*<sub>C</sub> is attributed to the Mn<sub>4</sub>Si<sub>7</sub> precipitates identified by electron diffraction. Possible origins of and are also discussed. Our findings raise questions regarding the origin of the high ferromagnetism reported in many material systems without a careful chemical analysis

Exploring infection prevention and control knowledge and beliefs in the Solomon Islands using Photovoice

Healthcare associated infections are the most common complication of a person’s hospital stay. Contemporary infection prevention and control programs are universally endorsed to prevent healthcare associated infections. However, western biomedical science on which contemporary infection prevention and control is based, is not the only way that staff and patients within healthcare settings understand disease causation and/or disease transmission. This results paper reports on one aspect of a study which ascertains perceptions of disease transmission and how these influence infection prevention and control practice at Atoifi Adventist Hospital Solomon Islands. Photovoice was used as the primary data collection method with staff and patients. The germ theory and hospital hygiene processes were only one of many explanations of disease transmission at the hospital. Many social, cultural and spiritual influences played an important role in how people understood disease to be transmitted. Although infection prevention and control models based on western science continue to form the premise of reducing healthcare associated infections in Solomon Islands and locations across the globe, local social, cultural and spiritual beliefs need to be considered when planning and implementing infection prevention and control programs to ensure success

High resolution structural characterisation of laser-induced defect clusters inside diamond

Laser writing with ultrashort pulses provides a potential route for the manufacture of three-dimensional wires, waveguides and defects within diamond. We present a transmission electron microscopy (TEM) study of the intrinsic structure of the laser modifications and reveal a complex distribution of defects. Electron energy loss spectroscopy (EELS) indicates that the majority of the irradiated region remains as $sp^3$ bonded diamond. Electrically-conductive paths are attributed to the formation of multiple nano-scale, $sp^2$-bonded graphitic wires and a network of strain-relieving micro-cracks