Effectiveness of LISTEN on Loneliness, Neuroimmunological Stress Response, Psychosocial Functioning, Quality of Life, and Physical Health Measures of Chronic Illness

Objectives: Loneliness is a biopsychosocial determinant of health and contributes to physical and psychological chronic illnesses, functional decline, and mortality in older adults. This paper presents the results of the first randomized trial of LISTEN, which is anew cognitive behavioral intervention for loneliness, on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and measures of physical health. Methods: The effectiveness of LISTEN was evaluated in a sample population comprising 27lonely, chronically ill, older adults living in Appalachia. Participants were randomized intoLISTEN or educational attention control groups. Outcome measures included salivary cortisol and DHEA, interleukin-6, interleukin-2, depressive symptoms, loneliness, perceived social support, functional ability, quality of life, fasting glucose, blood pressure, and body mass index. Results: At 12 weeks after the last intervention session, participants of the LISTEN group reported reduced loneliness (p¼0.03), enhanced overall social support(p¼0.05), and decreased systolic blood pressure (p¼0.02). The attention control group reported decreased functional ability (p¼0.10) and reduced quality of life (p¼0.13). Conclusions: LISTEN can effectively diminish loneliness and decrease the systolic blood pressure in community-dwelling, chronically ill, older adults. Results indicate that this population, if left with untreated loneliness, may experience functional impairment over a period as short as 4 months. Further studies on LISTEN are needed with larger samples, in varied populations, and over longer periods of time to assess the long-term effects of diminishing loneliness in multiple chronic condition

Nitrogen Input Effects on Herbage Accumulation and Presence of Pasture Plant Species

Long-term responses of pasture plant species to management strategies that vary amount and form of N inputs form a knowledge gap. Our objective was to determine how supplementation of grazing beef cattle (Bos taurus) with corn (Zea mays L.) dried distillers grains plus solubles (DDGS) in unfertilized pasture (SUPP) affects annual herbage accumulation and presence of plant species and functional groups relative to unsupplemented beef cattle on unfertilized (CONT) and N-fertilized (FERT) smooth bromegrass (Bromus inermis Leyss.) pasture. We addressed this objective in the sixth (2010) and seventh (2011) years of a long-term experiment in eastern Nebraska, where N input from DDGS supplementation and urea fertilizer averaged 0, 43, and 90 kg ha–1 yr–1 within CONT, SUPP, and FERT, respectively. For these years, annual herbage accumulation averaged 6.87, 6.80, and 10.58 Mg ha–1 (LSD = 1.49) and 66.5, 66.2, and 76.0% of herbage accumulated by 25 June (LSD = 5.3) in CONT, SUPP, and FERT, respectively. Smooth bromegrass occurred in 99.8% of 0.1-m2 pasture quadrats regardless of treatment. Cessation of N fertilizer input, however, increased presence of annual foxtail (Setaria spp.), annual graminoids, and annuals among quadrats in CONT relative to FERT. Supplementation of DDGS, while shown in previous studies to improve weight gains and N use efficiency in cattle, supplied enough N through excretion to provide an intermediate level of resistance to annual weeds. Nitrogen excreted from cattle supplemented with DDGS, however, did not aff ect herbage accumulation in subsequent years

Targeted muscle reinnervation for the management of pain in the setting of major limb amputation

The life altering nature of major limb amputations may be further complicated by neuroma formation in up to 60% of the estimated 2 million major limb amputees in the United States. This can be a source of pain and functional limitation of the residual limb. Pain associated with neuromas may limit prosthetic limb use, require reoperation, lead to opioid dependence, and dramatically reduce quality of life. A number of management options have been described including excision alone, excision with repair, excision with transposition, and targeted muscle reinnervation. Targeted muscle reinnervation has been shown to reduce phantom limb and neuroma pain for patients with upper and lower extremity amputations. It may be performed at the time of initial amputation to prevent pain development or secondarily for the treatment of established pain. Encouraging outcomes have been reported, and targeted muscle reinnervation is emerging as a leading surgical technique for pain prevention in patients undergoing major limb amputations and pain management in patients with pre-existing amputations

Hypothalamic Vitamin D Improves Glucose Homeostasis and Reduces Weight

Despite clear associations between vitamin D deficiency and obesity and/or type 2 diabetes, a causal relationship is not established. Vitamin D receptors (VDRs) are found within multiple tissues, including the brain. Given the importance of the brain in controlling both glucose levels and body weight, we hypothesized that activation of central VDR links vitamin D to the regulation of glucose and energy homeostasis. Indeed, we found that small doses of active vitamin D, 1α,25-dihydroxyvitamin D3 (1,25D3) (calcitriol), into the third ventricle of the brain improved glucose tolerance and markedly increased hepatic insulin sensitivity, an effect that is dependent upon VDR within the paraventricular nucleus of the hypothalamus. In addition, chronic central administration of 1,25D3 dramatically decreased body weight by lowering food intake in obese rodents. Our data indicate that 1,25D3-mediated changes in food intake occur through action within the arcuate nucleus. We found that VDR colocalized with and activated key appetite-regulating neurons in the arcuate, namely proopiomelanocortin neurons. Together, these findings define a novel pathway for vitamin D regulation of metabolism with unique and divergent roles for central nervous system VDR signaling. Specifically, our data suggest that vitamin D regulates glucose homeostasis via the paraventricular nuclei and energy homeostasis via the arcuate nuclei

Tuberculosis from Mycobacterium bovis in Binational Communities, United States

The incidence in San Diego is increasing and is concentrated mostly in persons of Mexican origin

Using post-measurement information in state discrimination

We consider a special form of state discrimination in which after the measurement we are given additional information that may help us identify the state. This task plays a central role in the analysis of quantum cryptographic protocols in the noisy-storage model, where the identity of the state corresponds to a certain bit string, and the additional information is typically a choice of encoding that is initially unknown to the cheating party. We first provide simple optimality conditions for measurements for any such problem, and show upper and lower bounds on the success probability. For a certain class of problems, we furthermore provide tight bounds on how useful post-measurement information can be. In particular, we show that for this class finding the optimal measurement for the task of state discrimination with post-measurement information does in fact reduce to solving a different problem of state discrimination without such information. However, we show that for the corresponding classical state discrimination problems with post-measurement information such a reduction is impossible, by relating the success probability to the violation of Bell inequalities. This suggests the usefulness of post-measurement information as another feature that distinguishes the classical from a quantum world.Comment: 10 pages, 4 figures, revtex, v2: published version, minor change

Reliability of the Myotonometer for Assessment of Posterior Shoulder Tightness

BACKGROUND/PURPOSE: The Myotonometer® is an electronic tissue compliance meter that has been used to quantify the compliance of soft tissues. The Myotonometer® may be a valuable tool to measure the effectiveness of interventions commonly used to increase tissue compliance in individuals with posterior shoulder tightness (PST). Limited data exist on reliability and responsiveness of the Myotonometer® for assessment of soft tissues about the shoulder; therefore, the purpose of this study is to determine the intra- and inter-session reliability and responsiveness of the Myotonometer® in measuring tissue compliance of the posterior shoulder musculature in asymptomatic subjects with PST. METHODS: Fifteen asymptomatic subjects with unilateral shoulder range of motion deficits attended two measurement sessions to assess the compliance of the tissues overlying the posterior deltoid, infraspinatus, and teres musculature. Analyses of reliability and responsiveness were conducted using intra-class correlation coefficients (ICCs) and the determination of minimal detectible change (MDC). RESULTS: Intra-session ICC values ranged from 0.69 to 0.91 for all muscles with MDC never exceeding 1.0 mm. Inter-session ICC values were best for the posterior deltoid, which averaged 0.82, compared to the infraspinatus and the teres complex, which averaged 0.42 and 0.5 respectively. Inter-session MDC ranged from 0.55 to 1.20 mm across all muscles. CONCLUSIONS: Clinicians can reliably detect relatively small changes in tissue compliance within a single treatment session utilizing the Myotonometer®. The Myotonometer® can reliably detect changes between sessions for tissues overlying the posterior deltoid; however, observed change in the infraspinatus and teres musculature must be above 1 mm to achieve meaningful change and account for decreased inter-session reliability. LEVEL OF EVIDENCE: 3

Conservative Treatment for Patients with Suspected SLAP Tears: A Case Series

Objective: Outcome following non-operative management of superior labral anterior to posterior (SLAP) lesions has been under reported with little empirical data demonstrating the effectiveness of conservative treatment. Material and Methods: 10 patients, 5 matched pairs, presenting with symptoms consistent with a SLAP lesion performed a standardized phased rehabilitation program completing patient reported outcome (PRO) and pain measures before and following rehabilitation. Physical therapy notes and home exercise logs were reviewed and all exercises were recorded and coded using the phased rehabilitation protocol as a guide. At followup, patients were divided into two groups; responders and non-responders to treatment based on PRO. The volume of exercise and type of exercise performed for each patient were compared using frequency counts. Results: The non-responders did on average 33 more stretching exercises than the responders. The non-responders did on average 21 more scapular orientation exercises than the responders. There were few to no differences in the volume of strengthening exercises between the two groups except responders performed 38 more scapular retraction exercises at shoulder level while non-responders performed 49 more scapular retraction exercises below shoulder level. Conclusions: This case series identified few exercises that were beneficial to patients\u27 responding to conservative intervention but more often identified exercises that were performed that did not facilitate an improved patient outcome. Therapeutic exercises are often the cornerstone of a rehabilitation program, yet limited evidence exists in which specific exercises are beneficial or not beneficial in patients with symptoms consistent with a SLAP lesion

Structural school characteristics and neighborhood risk factors: Associations with student-reported school climate in a large, urban public school district in the United States

IntroductionSchool climate consistently predicts youth academic success, social–emotional well-being, and substance use, and positive school climate can buffer the negative effects of community violence exposure on youth development. Various structural school and neighborhood factors have been associated with school climate, but prior research has not examined these relations comprehensively.MethodsWe examined the relation between 18 school building and school neighborhood factors with student-reported school climate among 15,833 students in 124 public schools in a large, urban district in the United States.ResultsIn this sample, attendance rate was most consistently associated with school climate (β = 0.015; p < 0.001). Teacher years of experience, mobility rate, number of students in special education, adult arrests in the school neighborhood, and service calls for shootings and dirty streets and alleys in the school neighborhood were also significantly associated with various domains of school climate.ConclusionsThese findings highlight the need for future longitudinal research on the influence of both school building and school neighborhood factors on school climate for public schools. Schools in our sample had a wide range of school climate scores despite consistently high crime rates and other structural risk factors such as low socioeconomic status throughout the city, so there are implications for researchers and education leaders to work together to identify opportunities for schools to foster positive school climate despite systemic school and/or neighborhood risk factors