Comparison of MRI and DXA to measure muscle size and age-related atrophy in thigh muscles.

OBJECTIVES Magnetic resonance imaging (MRI) and dual-energy x-ray absorptiometry (DXA) were used to examine the thigh lean mass in young and old men and women. METHODS A whole-body DXA scan was used to estimate thigh lean mass in young (20 men; 22.4±3.1y; 18 women; 22.1±2.0y) and older adults (25 men; 72.3±4.9y; 28 women; 72.0±4.5y). Thigh lean mass determined with a thigh scan on the DXA or full thigh MRI scans were compared. RESULTS Although the thigh lean mass quantified by DXA and MRI in young and older participants were correlated (R(2)=0.88; p<0.001) the magnitude of the differences in thigh lean mass between young and old was smaller with DXA than MRI (old vs. young men 79.5±13.1% and 73.4±11.2%; old vs. young women 88.6±11.8% and 79.4±12.3%, respectively). Detailed analysis of MRI revealed 30% smaller quadriceps muscles in the older than young individuals, while the other thigh muscles were only 18% smaller. CONCLUSIONS DXA underestimates the age-related loss of thigh muscle mass in comparison to MRI. The quadriceps muscles were more susceptible to age-related atrophy compared with other thigh muscles

Effects of diabetes family history and exercise training on the expression of adiponectin and leptin and their receptors

The daughters of patients with diabetes have reduced insulin sensitivity index (ISI) scores compared with women with no family history of diabetes, but their ISI increase more in response to exercise training(1). The present study aimed to determine whether differences between these groups in exercise-induced changes in circulating adiponectin and leptin concentrations and expression of their genes and receptors in subcutaneous adipose tissue (SAT), could explain differences in the exercise-induced changes in ISI between women with and without a family history of diabetes

Automated Analysis and Quantification of Human Mobility using a Depth Sensor

Analysis and quantification of human motion to support clinicians in the decision-making process is the desired outcome for many clinical-based approaches. However, generating statistical models that are free from human interpretation and yet representative is a difficult task. In this work, we propose a framework that automatically recognises and evaluates human mobility impairments using the Microsoft Kinect One depth sensor. The framework is composed of two parts. Firstly, it recognises motions, such as sit-to-stand or walking 4 metres, using abstract feature representation techniques and machine learning. Secondly, evaluation of the motion sequence in the temporal domain by comparing the test participant with a statistical mobility model, generated from tracking movements of healthy people. To complement the framework, we propose an automatic method to enable a fairer, unbiased approach to label motion capture data. Finally, we demonstrate the ability of the framework to recognise and provide clinically relevant feedback to highlight mobility concerns, hence providing a route towards stratified rehabilitation pathways and clinician led interventions

The intention to hasten death: a survey of attitudes and practices of surgeons in Australia

Objective: To determine attitudes among surgeons in Australia to assisted death, and the proportion of surgeons who have intentionally hastened death with or without an explicit request. Design: Anonymous, cross-sectional, mail-out survey between August and November 1999. Participants: 683 out of 992 eligible general surgeons (68.9% response rate). Main outcome measures: Proportion of respondents answering affirmatively to questions about administering excessive doses of medication with an intention to hasten death. Results: 247 respondents (36.2%; 95% CI, 32.6%-39.9%) reported that, for the purpose of relieving a patient's suffering, they have given drugs in doses that they perceived to be greater than those required to relieve symptoms with the intention of hastening death. More than half of these (139 respondents; 20.4% of all respondents; 95% CI, 17.4%-23.6%) reported that they had never received an unambiguous request for a lethal dose of medication. Of all respondents, only 36 (5.3%; 95% CI, 2.9%-6.1%) reported that they had given a bolus lethal injection, or had provided the means to commit suicide, in response to an unambiguous request. Conclusions: More than a third of surgeons surveyed reported giving drugs with an intention to hasten death, often in the absence of an explicit request. However, in many instances, this may involve the use of an infusion of analgesics or sedatives, and such actions may be difficult to distinguish from accepted palliative care, except on the basis of the doctor's self-reported intention. Legal and moral distinctions based solely on a doctor's intention are problematic

The intention to hasten death: a survey of attitudes and practices of surgeons in Australia

Objective: To determine attitudes among surgeons in Australia to assisted death, and the proportion of surgeons who have intentionally hastened death with or without an explicit request. Design: Anonymous, cross-sectional, mail-out survey between August and November 1999. Participants: 683 out of 992 eligible general surgeons (68.9% response rate). Main outcome measures: Proportion of respondents answering affirmatively to questions about administering excessive doses of medication with an intention to hasten death. Results: 247 respondents (36.2%; 95% CI, 32.6%-39.9%) reported that, for the purpose of relieving a patient's suffering, they have given drugs in doses that they perceived to be greater than those required to relieve symptoms with the intention of hastening death. More than half of these (139 respondents; 20.4% of all respondents; 95% CI, 17.4%-23.6%) reported that they had never received an unambiguous request for a lethal dose of medication. Of all respondents, only 36 (5.3%; 95% CI, 2.9%-6.1%) reported that they had given a bolus lethal injection, or had provided the means to commit suicide, in response to an unambiguous request. Conclusions: More than a third of surgeons surveyed reported giving drugs with an intention to hasten death, often in the absence of an explicit request. However, in many instances, this may involve the use of an infusion of analgesics or sedatives, and such actions may be difficult to distinguish from accepted palliative care, except on the basis of the doctor's self-reported intention. Legal and moral distinctions based solely on a doctor's intention are problematic

The Wow Factor? A Comparative Study of the Development of Student Music Teachers' Talents in Scotland and Australia

For some time there has been debate about differing perspectives on musical gift and musical intelligence. One view is that musical gift is innate: that it is present in certain individuals from birth and that the task of the teacher is to develop the potential which is there. A second view is that musical gift is a complex concept which includes responses from individuals to different environments and communities (Howe and Sloboda, 1997). This then raises the possibility that musical excellence can be taught. We have already explored this idea with practising musicians (Stollery and McPhee, 2002). Our research has now expanded to include music teachers in formation, and, in this paper, we look at the influences in their musical development which have either 'crystallised' or 'paralysed' the musical talent which they possess. Our research has a comparative dimension, being carried out in Scotland and in Australia. We conclude that there are several key influences in the musical development of the individual, including home and community support, school opportunities and teaching styles and that there may be education and culture-specific elements to these influences

Risk factors for wound infection in surgery for spinal metastasis

Wound infection rates are generally higher in patients undergoing surgery for spinal metastasis. Risk factors of wound infection in these patients are poorly understood. Purpose To identify demographic and clinical variables that may be associated with patients experiencing a higher wound infection rate. Study design Retrospective study with prospectively collected data of spinal metastasis patients operated consecutively at a University Teaching Hospital, adult spine division which is a tertiary referral centre for complex spinal surgery. Patient sample Ninety-eight patients were all surgically treated, consecutively from January 2009 to September 2011. Three patients had to be excluded due to inadequate data. Outcome measures Physiological measures, with presence or absence of microbiologically proven infection. Methods Various demographic and clinical data were recorded, including age, serum albumin level, blood total lymphocyte count, corticosteroid intake, Malnutrition Universal Screening Tool (MUST) score, neurological disability, skin closure material used, levels of surgery and administration of peri-operative corticosteroids. No funding was received from any sources for this study and as far as we are aware, there are no potential conflict of interest-associated biases in this study. Results Higher probabilities of infection were associated with low albumin level, seven or more levels of surgery, use of delayed/non-absorbable skin closure material and presence of neurological disability. Of these factors, levels of surgery were found to be statistically significant at the 5 % significance level. Conclusion Risk of infection is high (17.9 %) in patients undergoing surgery for spinal metastasis. Seven or more vertebral levels of surgery increase the risk of infection significantly (p < 0.05). Low albumin level and presence of neurological disability appear to show a trend towards increased risk of infection. Use of absorbable skin closure material, age, low lymphocyte count, peri-operative administration of corticosteroids and MUST score do not appear to influence the risk of infection

Criminal justice responses to domestic violence and abuse in England: an analysis of case attrition and inequalities using police data

Responding to domestic violence and abuse (DVA) poses significant challenges for the criminal justice system, with recent studies highlighting a number of significant gaps and failings in the nature of the police response in particular. This paper reports on findings from a component of the multi-stage ESRC funded project ‘Justice, Inequality and Gender-Based Violence’ (ESRC grant ES/M010090/1) that relates to 400 reported incidents of DVA involving intimate partners recorded by two police force areas in England in 2014. Drawing on this large data set concerning a wide range of incidents, this paper employs quantitative methods to analyse the trajectories of reports made to the police, and the factors that may influence their progress through, or attrition from the criminal justice system. In doing so, this paper finds that certain ‘inequality’ factors such as victim gender, vulnerability (including mental health) and incident type are found to impact the progression of cases through the criminal justice system. This work seeks to build on our understanding of what happens to incidents of DVA that are brought to the attention of the police by victims and survivors, and reflects upon how the outcomes of such incidents impact the broader debate concerning the pursuit of a formal, or criminal ‘justice’ in cases of DVA