Regulatory Taking: A Contract Approach

This Article begins by defining the parameters of the fifth amendment\u27s taking clause. The Article then reviews the various tests used in determining whether governmental action constitutes a taking, and discusses the recent Supreme Court decisions within the framework of case law as it has evolved since the Court\u27s 1922 landmark decision, Pennsylvania Coal Co. v. Mahon. Finally, the Article suggests a formula based on well-established contract principles for analyzing the impact of land use regulation on private property interests

Children and adolescents with chronic pain: parental factors, functioning, and neurodevelopmental comorbidity

Background: Pediatric chronic pain affects between 11 and 38% of all children. Although pain may result from injury or disease, the cause of chronic pain is commonly unclear. The interaction between biological, psychological, and social aspects has been emphasized as key to the understanding of the chronic pain experience, as well as risk and resilience factors. Pediatric chronic pain may result in significant impairment affecting both child and family functioning, and addressing family factors such as parental distress and protective behaviors, are generally considered important to pediatric chronic pain management. However, there is still a need to identify resilience factors that can be targeted in parental support programs, and to develop and evaluate effective parent support interventions. The complexity of the pain experience in pediatric chronic pain is well known with a large number of patients suffering from co-occurring disorders such as depression or insomnia. However, despite a considerable number of clinical observations suggesting an elevated prevalence of attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) among children with chronic pain, and similarities in terms of clinical correlates, the empirical support has been scarce. More research on the co-occurrence of pediatric chronic pain, ADHD, and ASD, including relationships with functioning, is therefore warranted. Purpose and aims: The purpose of the present research project was to identify and assess parental and child factors of importance for functioning and treatment effects in pediatric chronic pain. More specifically, the aims of the project were to: validate an instrument for parental psychological flexibility (Study I); evaluate the effects of a brief parental ACTintervention on parent outcomes (Study II); assess the prevalence of clinically significant traits and symptoms of ASD and ADHD in children, and relations to pain- and demographic variables (Study III); and, to explore the relationships between traits and symptoms of ASD and ADHD, functioning, and health-related quality of life (HRQoL) (Study IV). Methods: In Study 1, utilizing a cross-sectional design, the Parent Psychological Flexibility Questionnaire (PPFQ) was translated and psychometrically evaluated in a sample of parents (n=263) of children with chronic pain using principal component analysis (PCA), correlation and regression analyses, and analysis of internal consistency. In Study II, the effects of individual and group ACT-interventions for adolescents (n=48) with chronic pain, and a brief support program for their parents (n=28), were evaluated using a randomized (group/individual) uncontrolled pilot design and non-parametric analyses of differences between groups and over time. In Study III, the prevalence of clinically significant ASD-traits and ADHD-symptoms was evaluated in a descriptive cross-sectional study on children with chronic pain (n=146) and their parents (n=146). Differences in painand demographic variables between children below and above cutoff for clinically significant traits and symptoms of ADHD or ASD were also assessed. Study IV, using the same sample as Study III, examined the relationships between ASD-traits and ADHDsymptoms, functioning (depression and pain interference), and HRQoL in correlation- and regression analyses and with independent t-tests, and assessed the indirect effects of insomnia and psychological inflexibility on the relationships between ASD-traits or ADHD-symptoms as predictors and functioning and HRQoL as dependents. Results: In Study 1, results supported a three-factor solution for the PPFQ with 10 items (PPFQ-10), showing good internal consistency and explaining a significant amount of variance in the criteria variables anxiety (29%) and depression (35.6%). In Study II, significant improvements in parental pain reactivity and psychological flexibility were found with clinically significant changes in the direction of better functioning for 54-76% of parents, with no differences between individual and group formats. In Study III, 13.7% of the sample presented with clinically significant ASD-traits and 19.9% of the sample presented with clinically significant ADHD-symptoms. The combined prevalence of clinically significant ASD/ADHD-traits and symptoms was 26%. Children with clinically significant ASD-traits were more likely to be girls and clinically significant ADHDsymptoms showed no gender differences. In Study IV, children with clinically significant ASD-traits and ADHD-symptoms presented with significantly higher levels of depressive symptoms and pain interference, and significantly lower HRQoL, compared to the rest of the sample. ASD-traits and ADHD-symptoms explained a significant amount of variance in pain interference and depressive symptoms, as well as in HRQoL. Psychological inflexibility was shown to mediate the influence of both ADHD-symptoms and ASD-traits, and insomnia the effect of ADHD-symptoms, on depression, pain interference, and HRQoL. Conclusions: Although tentative, the results suggests the utility of addressing parental psychological flexibility in relation to pediatric chronic pain. However, more research is warranted and future studies should e.g. evaluate the predictive utility of the PPFQ for child treatment outcomes, and evaluate if parental support programs that increase parental psychological flexibility also have positive effects on the children. Also, the results provide empirical support regarding elevated levels of clinically significant ADHD-symptoms and ASD-traits in pediatric chronic pain, and illustrate significant relationships between such traits and symptoms and functioning in children. Children with debilitating chronic pain, particularly girls, may be at risk for having a comorbid, and possibly undetected highfunctioning neurodevelopmental disorder. Results thus suggest the utility of screening for neurodevelopmental disorders in children with chronic pain, and may indicate insomnia, and psychological flexibility as potential treatment targets to improve functioning and HRQoL. The results also warrant further research to e.g. validate these findings in larger studies, evaluate the utility of tailored interventions, and examine the shared neuropathophysiology of chronic pain and neurodevelopmental disorders, including dopamine function and sensory abnormalities

EFFECTS OF AEROBIC EXERCISE ON INDIVIDULAS WITH DOWN SYNDROME VIA TELEREHABILITATION

BACKGROUND: Most of the children and adolescents with Down’s syndrome (DS) have poor aerobic capacity, physical fitness and demonstrate diminished cognitive abilities. Recent studies suggest that increased physical activity may prove to be important for maintaining components of cognition, including memory along with physical fitness. In addition, there is interest among practitioners in determining the efficacy of virtual exercise classes, which can be more convenient for clients. However, it is unknown whether group exercise classes delivered over videoconferencing achieve desired outcomes—particularly in special populations such as those with DS. PURPOSE: The purpose of this study is to evaluate the effect of aerobic exercise practiced over video conferencing on physical fitness and cognition in individuals with DS METHOD: A pilot study was carried out with 5 individuals having DS. 10 weeks of an aerobic exercise protocol of moderate intensity was delivered via videoconferencing. Before and after the 10-week intervention, VO2max was estimated using a previously established method, and cognitive ability was assessed using a 61-item questionnaire. RESULT: Following the 10-week intervention, significant increases were noted for both aerobic fitness as well as cognitive abilities CONCLUSION: Aerobic exercises will help to maintain or improve physical fitness in individuals with DS. Perhaps more importantly, it is also apparent that aerobic exercise positively affects cognitive function as well. Videoconferencing is an effective platform for delivering aerobic exercise prescriptions in cases where in-person practice is not possible. Future work is needed to determine whether these outcomes are achieved with a larger sample and across a broader population of those with DS

Make Reading Fun: Implications of Virtual Reality on Standing Balance and Control

The recent rapid expansion of virtual reality (VR) technology is driving a widespread number of new applications, including providing immersive environments for users to learn and read through commercially-available applications. However, recent research has shown that VR causes symptoms of dizziness and motion sickness, which could disrupt users gait and balance. Thus, it is important to understand how to best mitigate these effects before VR use becomes more widespread across the lay public. PURPOSE: The purpose of this study was to determine the acute effect of VR use on gait and balance control following use, and whether aspects of virtual environment design can mitigate negative effects.. METHODS: 60 young, healthy participants read a short story for 45 minutes while immersed in VR.They were randomly assigned to read in one of three environments: 1) a cluttered library, 2) a bright snowy landscape and 3) a dark outer space scene. These environments were selected due to their differences in visual clutter and lighting–VR design considerations which have been shown in previous work to influence visual fatigue and motion sickness. Prior to and following VR use, participants completed three standing balance tasks(standing balance, eyes open; standing balance, eyes closed and single leg stance) and two gait tasks (tandem walking and regular gait). While completing these tasks, kinematic and ground reaction force data were collected from an 8-camera 3D motion capture system and two force plates in order to assess changes in gait and balance kinematics and kinetics. RESULTS: Preliminary results (n = 12) indicate that those who read in the dark outer space environment demonstrated diminished balance control, as evidenced in an increase in center of pressure velocity during single leg balance. CONCLUSION: This finding indicates that the type of virtual environment a person is immersed in can affect their sense of balance following use. Specific to the dark outer space environment, it is possible the lack of visual anchors (i.e., nothing for them to focus on) lead to visual fatigue and downstream balance effects. Additional data analysis will help to elucidate these findings, which could lend insight to the role of virtual environment design on the user experience

A.R.G! Augmented Reality and Gait: Analyzing the Influence of Cues on Gait Patterns in Augmented Reality

Use of Augmented Reality (AR) technology for rehabilitation has drastically increased in recent years. While theoretically AR can be used to cue gait adaptations such as changes to step length and cadence through visual and auditory cues, it is still unknown how people respond to the technology. PURPOSE: To assess the feasibility of external visual and auditory cues delivered through AR on spatiotemporal gait outcomes in a healthy, young population. METHODS: 20 healthy participants between age 18 and 35 were screened and recruited to perform randomized gait trials consisting of four different cueing conditions. The participants wore a Magic Leap One AR headset with a custom-designed cueing application. Participants were instructed to walk 10 steps under one of four cueing conditions provided by the AR application: No Cues (NC) (i.e., natural gait), Visual (V), Auditory (A), and Visual and Auditory (VA). Each condition was completed three times in a randomized order for a total of 12 trials per participant. An Inertial Measurement Unit (IMU) system was used to collect spatiotemporal gait data. A System Usability Survey (SUS) was administered after each participant completed their trials to determine the usability of our novel application and to determine whether the reported usability of the system was related to changes in gait variability. RESULTS: Preliminary results indicate all cueing conditions exhibited a significantly faster cadence compared to NC trials. Surprisingly, the cadence variability increased across all A trials. Increased system usability SUS results were significantly correlated with increased percent stance variability across A trials. V trials exhibited significantly decreased stride lengths compared to NC. Combined (AV) cues had no effect on gait outcomes. CONCLUSION: Our findings reinforced that certain visual and auditory cues affect gait parameters, albeit in a direction opposite of what was expected (e.g., greater cadence variability with auditory cues). These results provide insight into how healthy populations respond to cues delivered through AR, as well as provide a foundation for future studies to implement this technology with clinical populations such as those with Parkinson’s disease

The prognostic importance of scalp location in primary head and neck melanoma.

BACKGROUND AND OBJECTIVES: For patients with cutaneous melanoma, primary tumors located in the head and neck is associated with poor outcomes. The reason for this difference and whether it is applicable to all locations within the head and neck remains unclear. We hypothesized that scalp melanoma is uniquely distinguished from other anatomic sites and is independently responsible for the poor prognosis of head and neck melanoma. METHODS: Query and analysis of a prospectively maintained melanoma database of all patients treated for primary cutaneous melanoma from 1971 to 2010. RESULTS: Of 11 384 patients identified, 7% (n = 799) of lesions originated on the scalp. Scalp primaries were more often found in males and were associated with increased Breslow thickness and were more frequently ulcerated compared to all other anatomic sites (P = 0.0001). On multivariate analysis, scalp location was an independent predictor of worse melanoma-specific (HR 1.75; CI 1.50-2.04; P \u3c 0.0001) and overall survival (HR 1.62; CI 1.41-1.86; P \u3c 0.0001). CONCLUSIONS: This, the largest series examining scalp melanoma, confirms that scalp location is independently responsible for the negative prognosis associated with head and neck melanoma. Although the pathophysiology of this difference remains to be determined, these data argue for more rigorous surveillance of this anatomic location

Just Bust a Move; Relating Subjective Evaluation to Objective Measurements in Hip – Hop Dance

Being globally recognized as a performance art and mode of expression, Hip - hop dance is becoming more prevalent in today’s modern dance and popular culture. With multiple renditions across the globe on what encompasses Hip - hop dance on various social media platforms and the different sub styles of hip-hop dance that currently exist, there are a limited number of ways to assess a dancer and their ability without relying on a high amount of subjectivity from those that are watching it. PURPOSE: To investigate the relationship between common dance moves (like the Arm Wave & Inverted Happy Feet) implemented into Hip - hop dance choreography and whether certain biomechanical aspects of those moves can predict how well a dancer may be evaluated in a competition. METHODS: Participants learned a brief Hip - hop dance routine, incorporating the aforementioned dance moves, for one week before data collection. After a brief warm up, the participants performed the learned dance choreography in a lab space while under a 3D motion capture system with force plates collecting kinematic and kinetic data. Video footage of each participant was also collected at this time. Videos of each participant’s performance footage was then sent out to judges for scoring, and a series of regression models were run to determine how well judge’s scores predicted discrete biomechanical variables related to performance of dance moves. RESULTS: Preliminary results suggest that displacement of the arm wave, propagation velocity of the arm wave, shape deviation of the arm wave, and ground reaction force symmetry during foot work have a significant role in predicting how a judge may score a dancer. CONCLUSION: These results indicate that the mechanical aspects of performing certain hip-hop dance moves are significant predictors of judges’ scoring, lending insight into the degree to which scoring is related to the mechanics of Hip – hop dance itself. Thus, a certain level of objectivity in judges’ scoring of hip-hop dance exists. Future work should consider how subjective factors such as age, sex/gender, and clothing choice may also influence judges’ scoring

The paradox of the binomial Ixodes ricinus activity and the observed unimodal Lyme borreliosis season in Hungary

The change of ambient temperature plays a key role in determining the run of the annual Lyme season. Our aim was to explain the apparent contradiction between the annual unimodal Lyme borreliosis incidence and the bimodal Ixodes ricinus tick activity run – both observed in Hungary – by distinguishing the temperaturedependent seasonal human and tick activity, the temperature-independent factors, and the multiplicative effect of human outdoor activity in summer holiday, using data from Hungary in the period of 1998–2012. This separation was verified by modeling the Lyme incidence based on the separated factors, and comparing the run of the observed and modeled incidence. We demonstrated the bimodality of tick season by using the originally unimodal Lyme incidence data. To model the outdoor human activity, the amount of camping guest nights was used, which showed an irregular run from mid-June to September. The human outdoor activity showed a similar exponential correlation with ambient temperature to that what the relative incidence did. It was proved that summer holiday has great influence on Lyme incidence