RUNNING SHOE STIFFNESS:THE EFFECT ON WALKING GAIT

Sports shoes can be grouped into various categories based on their stability, protection capabilities, traction, impact characteristics and stiffness. The majority of shoe tests involve measures of traction and impact. Few studies have examined shoe sole stiffness. Therefore, the purpose of this study was to assess shoe sole stiffness by a materials testing procedure, and then examine the effect of shoe stiffness on walking gait. A damped oscillation technique, previously used on muscle-tendon complexes, was utilised to calculate the stiffness and the damping factor of six types of running shoes. The shoes used different rnidsole components which included air sacs, gel sacs, ethylene vinyl acetate (EVA), and kevlar reinforcing. Two shoes at the extremes of the range were then selected from the materials test results for use in the subsequent gait analysis. Nine males ranging in age from 25 to 45 years (mean =36 years) participated in the experiment. Heights ranged from 186cm to 176cm (mean=182cm) and weights ranged from 72.5kg to 89kg (mean=8lkg). No subjects had any musculoskeletal problems affecting the lower limb. Two dimensional video data were collected on the right leg using an Ariel Video Analysis system sampling at 50 Hz, as subjects walked at 5.1 km/hr on a motor driven treadmill. Markers were placed on the greater trochanter, lateral condyle of the femur, lateral malleolus of the fibular, the heel of the shoe and on the shoe at the level of the fifth metatarsal head. Three stride cycles were collected after the subjects had walked on the treadmill for one minute. Data were digitised and downloaded to FMAP software to calculate kinematic variables such as knee and ankle angle and knee and ankle angular velocity. Data were then normalised to 50 points and averaged across stride cycles and subjects. Although a comparison of the stiff and flexible shoes indicated no differences in the kinematic parameters (p>0.05), it may be that the muscles of the lower limb adjust their activity level for the stiffness of the shoe to maintain an invariant kinematic pattern

Residual cognitive deficits 50 years after lead poisoning during childhood

The long term neurobehavioural consequences of childhood lead poisoning are not known. In this study adult subjects with a documented history of lead poisoning before age 4 and matched controls were examined with an abbreviated battery of neuropsychological tests including measures of attention, reasoning, memory, motor speed, and current mood. The subjects exposed to lead were inferior to controls on almost all of the cognitive tasks. This pattern of widespread deficits resembles that found in children evaluated at the time of acute exposure to lead rather than the more circumscribed pattern typically seen in adults exposed to lead. Despite having completed as many years of schooling as controls, the subjects exposed to lead were lower in lifetime occupational status. Within the exposed group, performance on the neuropsychological battery and occupational status were related, consistent with the presumed impact of limitations in neuropsychological functioning on everyday life. The results suggest that many subjects exposed to lead suffered acute encephalopathy in childhood which resolved into a chronic subclinical encephalopathy with associated cognitive dysfunction still evident in adulthood. These findings lend support to efforts to limit exposure to lead in childhood

Developing a core outcome set for fistulising perianal Crohn's disease

OBJECTIVE: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD. DESIGN: Candidate outcomes were generated through a systematic review and patient interviews. Consensus was established via a three-round Delphi process using a 9-point Likert scale based on how important they felt it was in determining treatment success culminating in a final consensus meeting. Stakeholders were recruited nationally and grouped into three panels (surgeons and radiologists, gastroenterologists and IBD specialist nurses, and patients). Participants received feedback fromtheir panel(in the second round) andall participants(in the third round) to allow refinement of their scores. RESULTS: A total of 295 outcomes were identified from systematic reviews and interviews that were categorised into 92 domains. 187 stakeholders (response rate 78.5%) prioritised 49 outcomes through a three-round Delphi study.The final consensus meeting of 41 experts and patients generated agreement on an eight domain COS. The COS comprised three patient-reported outcome domains (quality of life, incontinence and a combined score of patient priorities) and five clinician-reported outcome domains (perianal disease activity, development of new perianal abscess/sepsis, new/recurrent fistula, unplanned surgery and faecal diversion). CONCLUSION: A fistulising pCD COS has been produced by all key stakeholders. Application of the COS will reduce heterogeneity in outcome reporting, thereby facilitating more meaningful comparisons between treatments, data synthesis and ultimately benefit patient care

Fashion retailing – past, present and future

This issue of Textile Progress reviews the way that fashion retailing has developed as a result of the application of the World Wide Web and information and communications technology (ICT) by fashion-retail companies. The review therefore first considers how fashion retailing has evolved, analysing retail formats, global strategies, emerging and developing economies, and the factors that are threatening and driving growth in the fashion-retail market. The second part of the review considers the emergence of omni-channel retailing, analysing how retail has progressed and developed since the adoption of the Internet and how ICT initiatives such as mobile commerce (m-commerce), digital visualisation online, and in-store and self-service technologies have been proven to support the progression and expansion of fashion retailing. The paper concludes with recommendations on future research opportunities for gaining a better understanding of the impacts of ICT and omni-channel retailing, through which it may be possible to increase and develop knowledge and understanding of the way the sector is developing and provide fresh impetus to an already-innovative and competitive industr

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

THE EFFECTS OF STRETCHING ON SERIES ELASTIC MUSCLE STIFFNESS AND PASSIVE RANGE OF MOTION

Sports people participating in activities involving running and jumping are vulnerable to Achilles tendon injuries. These injuries occur from either acute trauma or develop more slowly over a longer period of time. "Warm up" exercises are often advocated for the prevention and treatment of muscle and tendon injuries. These exercises usually include aerobic and stretching exercises, however, at this time the effect of these "warm up" regimes is largely anecdotal. Therefore the purpose of this investigation was to determine the effect of stretching and jogging on the series elastic muscle stiffness of the Soleus/Achilles tendon complex and on the range of motion of the ankle joint. Twenty subjects with no history of musculoskeletal pathology participated in this study, and were required for four testing sessions. In the first session maximum voluntary contraction (MVC) was assessed so that subsequent stiffness testing would be at 30% of their MVC. In the second session subjects were randomly assigned to one of a stretching, jogging, or stretching and jogging combined protocol. During the third and forth sessions the subjects completed the remaining protocols. The stretching protocol was five 30 second static stretches with 30 seconds rest between stretches, while the aerobic exercise protocol had the subjects jogging on a treadmill for 10 minutes at 60% of maximum-age-predicted heart rate. A damped oscillation technique was used to measure the series elastic stiffness of the Soleus/Achilles tendon complex. Range of motion was assessed using weights and a pulley system to move the ankle joint through its range passively. EMG of soleus was monitored to ensure muscle activity was minimal. The results for stiffness showed that running was significantly (pd.05) more effective than stretching for decreasing series elastic muscle stiffness. In contrast, the results for range of motion showed that a combination of running and stretching were significantly (peO.05) better than either running or stretching separately for increasing joint range of motion. These data have implications for the sports participant. It may be best to prepare for activities with extreme ranges of motion by combining an aerobic warmup with stretching. Those involved in movements not reaching the limits of joint motion may be best served by an aerobic warmup only

The effect of aircraft control forces on pilot performance during instrument landings in a flight simulator

BACKGROUND: Pilots may have difficulty controlling aircraft at both high and low force levels due to larger variability in force production at these force levels. The aim of this study was to measure the force variability and landing performance of pilots during an instrument landing in a flight simulator. METHODS: There were 12 pilots who were tested while performing 5 instrument landings in a flight simulator, each of which required different control force inputs. Pilots can produce the least force when pushing the control column to the right, therefore the force levels for the landings were set relative to each pilot's maximum aileron-right force. The force levels for the landings were 90%, 60%, and 30% of maximal aileron-right force, normal force, and 25% of normal force. Variables recorded included electromyographic activity (EMG), aircraft control forces, aircraft attitude, perceived exertion and deviation from glide slope and heading. Multivariate analysis of variance was used to test for differences between landings. RESULTS: Pilots were least accurate in landing performance during the landing at 90% of maximal force (p < 0.05). There was also a trend toward decreased landing performance during the landing at 25% of normal force. Pilots were more variable in force production during the landings at 60% and 90% of maximal force (p < 0.05). CONCLUSION: Pilots are less accurate at performing instrument landings when control forces are high due to the increased variability of force production. The increase in variability at high force levels is most likely associated with motor unit recruitment, rather than rate coding. Aircraft designers need to consider the reduction in pilot performance at high force levels, as well as pilot strength limits when specifying new standards