Curved Walking Rehabilitation with a Rotating Treadmill in Patients with Parkinson’s Disease: A Proof of Concept

Training subjects to step-in-place eyes open on a rotating platform while maintaining a fixed body orientation in space [podokinetic stimulation (PKS)] produces a posteffect consisting in inadvertent turning around while stepping-in-place eyes closed [podokinetic after-rotation (PKAR)]. Since the rationale for rehabilitation of curved walking in Parkinson's disease is not fully known, we tested the hypothesis that repeated PKS favors the production of curved walking in these patients, who are uneasy with turning, even when straight walking is little affected. Fifteen patients participated in 10 training sessions distributed in 3 weeks. Both counterclockwise and clockwise PKS were randomly administered in each session. PKS velocity and duration were gradually increased over sessions. The velocity and duration of the following PKAR were assessed. All patients showed PKAR, which increased progressively in peak velocity and duration. In addition, before and at the end of the treatment, all patients walked overground along linear and circular trajectories. Post-training, the velocity of walking bouts increased, more so for the circular than the linear trajectory. Cadence was not affected. This study has shown that parkinsonian patients learn to produce turning while stepping when faced with appropriate training and that this capacity translates into improved overground curved walking

Dall’uncino ai container : i lavoratori portuali a Genova e Venezia (1945-1989)

From the hook to containerization. The dock workers in Genoa and Venice (1945-1969) The goal of my research is to answer the following question: What were the occupational and social consequences of the containerization, in terms of the way dock labour forces were governed in Genoa and Venice? The container revolution started in the United States and spread throughout the world. In the first part of my doctoral thesis, I show how I adopt the theoretical approach of the Global labour history and the international literature on the dock workers history. In the second and third parts, I narrate the history of longshoremen in Genoa and Venice. From IIW the dock workers cooperative had been and very interesting institutions on cultural and political plane. I analyzed the technological innovation promoted by North American ship owners and I show the links between Italian harbors and North American ship owners or Asian waterfronts. The local-global dialectic is useful to avoid the placement of Genoa and Venetian ports in a purely historical nationalist framework, or in provincial narration

Writing Blindly in Incomplete Locked-In Syndrome with A Custom-Made Switch-Operated Voice-Scanning Communicator—A Case Report

Background: Locked-In Syndrome (LIS) is a rare neurological condition in which patients’ ability to move, interact, and communicate is impaired despite their being conscious and awake. After assessing the patient’s needs, we developed a customized device for an LIS patient, as the commercial augmentative and alternative communication (AAC) devices could not be used. Methods: A 51-year-old woman with incomplete LIS for 15 years came to our laboratory seeking a communication tool. After excluding the available AAC devices, a careful evaluation led to the creation of a customized device (hardware + software). Two years later, we assessed the patient’s satisfaction with the device. Results: A switch-operated voice-scanning communicator, which the patient could control by residual movement of her thumb without seeing the computer screen, was implemented, together with postural strategies. The user and her family were generally satisfied with the customized device, with a top rating for its effectiveness: it fit well the patient’s communication needs. Conclusions: Using customized AAC and strategies provides greater opportunities for patients with LIS to resolve their communication problems. Moreover, listening to the patient’s and family’s needs can help increase the AAC’s potential. The presented switch-operated voice-scanning communicator is available for free on request to the authors

Comparison of Two Techniques Performing the Supine-to-Sitting Postural Change in Patients with Sternotomy

Patients with sternotomy are advised to follow sternal precautions to avoid the risk of sternal complications. However, there are no standard recommendations, in particular to perform the supine-to-sitting postural change, where sternal asymmetrical force may be applied. The aim of this study was to compare the rotational movement and the use of a tied rope (individual device for supine-to-sitting, “IDSS”) to perform the supine-to-sitting postural change. A total of 92 patients (26% female) admitted to a rehabilitative post-surgery ward with sternotomy were assessed for sternal instability. Levels of pain and perceived effort during the two modalities of postural change and at rest were assessed. Patients reported higher values of pain and perceived effort (both p < 0.0005) during rotational movement with respect to the use of the IDSS. Moreover, patients with sternal instability (14%) and female patients with macromastia (25%) reported higher pain than those stable or without macromastia (both p < 0.05). No other risk factors were associated with pain. Thus, the IDSS seems to reduce the levels of pain and perceived effort during the supine-to-sitting postural change. Future studies with quantitative assessments are required to suggest the adoption of this technique, mostly in patients with high levels of pain or with sternal instability

Shifting Shores of the Anthropocene: The Settlement and (Unstable) Stabilisation of the North-Western Mediterranean Littoral Over the Nineteenth and Twentieth Centuries

Human occupation of the littoral has dramatically increased in the modern era, leading to major ecological and morphological changes of the coastal zone that are central to current debates on the Anthropocene. While the existing interpretations tend to represent these changes in terms of human impact and despoliation, we argue that exclusive insistence on this aspect risks obfuscating the inherent dynamism and persistent instability of coastal environments, while erasing the differences in how historical actors interacted with this dynamism. Focusing on the north-western Mediterranean, we investigate the interaction between stabilisation and instability - the shifting nature of the shores. Based on an extensive analysis of secondary sources in five languages (Italian, French, Catalan, Spanish and English), we propose a tripartite analytical framework: first, we analyse new understandings of the coast; second, coastal integration and networks; finally, the physical transformations of the coastal environment. Through this approach, the paper sheds light on the contested and ultimately elusive stabilisation which accompanied modern coastal settlement and invites the reader to think historically about the Anthropocene from the perspective of shifting shores.</jats:p

Shifting Shores of the Anthropocene: The Settlement and (Unstable) Stabilisation of the North-Western Mediterranean Littoral Over the Nineteenth and Twentieth Centuries

Human occupation of the littoral has dramatically increased in the modern era, leading to major ecological and morphological changes of the coastal zone that are central to current debates on the Anthropocene. While the existing interpretations tend to represent these changes in terms of human impact and despoliation, we argue that exclusive insistence on this aspect risks obfuscating the inherent dynamism and persistent instability of coastal environments, while erasing the differences in how historical actors interacted with this dynamism. Focusing on the north-western Mediterranean, we investigate the interaction between stabilisation and instability – the shifting nature of the shores. Based on an extensive analysis of secondary sources in five languages (Italian, French, Catalan, Spanish and English), we propose a tripartite analytical framework: first, we analyse new understandings of the coast; second, coastal integration and networks; finally, the physical transformations of the coastal environment. Through this approach, the paper sheds light on the contested and ultimately elusive stabilisation which accompanied modern coastal settlement and invites the reader to think historically about the Anthropocene from the perspective of shifting shores

Shifting Shores of the Anthropocene: The Settlement and (Unstable) Stabilisation of the North-Western Mediterranean Littoral Over the Nineteenth and Twentieth Centuries

International audienceHuman occupation of the littoral has dramatically increased in the modern era, leading to major ecological and morphological changes of the coastal zone that are central to current debates on the Anthropocene. While the existing interpretations tend to represent these changes in terms of human impact and despoliation, we argue that exclusive insistence on this aspect risks obfuscating the inherent dynamism and persistent instability of coastal environments, while erasing the differences in how historical actors interacted with this dynamism. Focusing on the north-western Mediterranean, we investigate the interaction between stabilisation and instability - the shifting nature of the shores. Based on an extensive analysis of secondary sources in five languages (Italian, French, Catalan, Spanish and English), we propose a tripartite analytical framework: first, we analyse new understandings of the coast; second, coastal integration and networks; finally, the physical transformations of the coastal environment. Through this approach, the paper sheds light on the contested and ultimately elusive stabilisation which accompanied modern coastal settlement and invites the reader to think historically about the Anthropocene from the perspective of shifting shores

Comparison of reliability, validity, and responsiveness of the Mini- BESTest and berg balance scale in patients with balance disorders

BACKGROUND: Recently, a new tool for assessing dynamic balance impairments has been presented: the 14-item Mini-BESTest. OBJECTIVE: The aim of this study was to compare the psychometric performance of the Mini-BESTest and the Berg Balance Scale (BBS). DESIGN: A prospective, single-group, observational design was used in the study. METHODS: Ninety-three participants (mean age=66.2 years, SD=13.2; 53 women, 40 men) with balance deficits were recruited. Interrater (3 raters) and test-retest (1-3 days) reliability were calculated using intraclass correlation coefficients (ICCs). Responsiveness and minimal important change were assessed (after 10 sessions of physical therapy) using both distribution-based and anchor-based methods (external criterion: the 15-point Global Rating of Change [GRC] scale). RESULTS: At baseline, neither floor effects nor ceiling effects were found in either the Mini-BESTest or the BBS. After treatment, the maximum score was found in 12 participants (12.9%) with BBS and in 2 participants (2.1%) with Mini-BESTest. Test-retest reliability for total scores was significantly higher for the Mini-BESTest (ICC=.96) than for the BBS (ICC=.92), whereas interrater reliability was similar (ICC=.98 versus .97, respectively). The standard error of measurement (SEM) was 1.26 and the minimum detectable change at the 95% confidence level (MDC(95)) was 3.5 points for Mini-BESTest, whereas the SEM was 2.18 and the MDC(95) was 6.2 points for the BBS. In receiver operating characteristic curves, the area under the curve was 0.92 for the Mini-BESTest and 0.91 for the BBS. The best minimal important change (MIC) was 4 points for the Mini-BESTest and 7 points for the BBS. After treatment, 38 participants evaluated with the Mini-BESTest and only 23 participants evaluated with the BBS (out of the 40 participants who had a GRC score of ≥ 3.5) showed a score change equal to or greater than the MIC values. LIMITATIONS: The consecutive sampling method drawn from a single rehabilitation facility and the intrinsic weakness of the GRC for calculating MIC values were limitations of the study. CONCLUSIONS: The 2 scales behave similarly, but the Mini-BESTest appears to have a lower ceiling effect, slightly higher reliability levels, and greater accuracy in classifying individual patients who show significant improvement in balance function

Writing with the Eyes: The Effect of Age on Eye-Tracking Performance in Non-Disabled Adults and a Comparison with Bimanual Typing

Eye-tracking technology is advancing rapidly, becoming cheaper and easier to use and more robust. This has fueled an increase in its implementation for Augmentative and Alternative Communication (AAC). Nowadays, Eye-Tracking Communication Devices (ETCDs) can be an effective aid for people with disabilities and communication problems. However, it is not clear what level of performance is attainable with these devices or how to optimize them for AAC use. The objective of this observational study was to provide data on non-disabled adults’ performance with ETCD regarding (a) range of eye-typing ability in terms of speed and errors for different age groups and (b) relationship between ETCD performance and bimanual writing with a conventional PC keyboard and (c) to suggest a method for a correct implementation of ETCD for AAC. Sixty-seven healthy adult volunteers (aged 20–79 years) were asked to type a sample sentence using, first, a commercial ETCD and then a standard PC keyboard; we recorded the typing speed and error rate. We repeated the test 11 times in order to assess performance changes due to learning. Performances differed between young (20–39 years), middle-aged (40–59 years), and elderly (60–79 years) participants. Age had a negative impact on performance: as age increased, typing speed decreased and the error rate increased. There was a clear learning effect, i.e., repetition of the exercise produced an improvement of performance in all subjects. Bimanual and ETCD typing speed showed a linear relationship, with a Pearson’s correlation coefficient of 0.73. The assessment of the effect of age on eye-typing performance can be useful to evaluate the effectiveness of man-machine interaction for use of ETCDs for AAC. Based on our findings, we outline a potential method (obviously requiring further verification) for the setup and tuning of ETCDs for AAC in people with disabilities and communication problems.</jats:p