Onset and persistence of person-perceived participation restriction in older adults: a 3-year follow-up study in the general population

<p>Abstract</p> <p>Background</p> <p>Participation restriction is defined as "problems an individual may experience in involvement in life situations" and refers to the personal and societal consequences of health conditions. There is a growing interest in participation restriction because (i) problems with work or looking after others may be more concerning to individuals than the signs and symptoms of health conditions and (ii) even when poor health persists, participation may still be maintained. The natural history of participation restriction in the general population is unknown and the aim of this report is to describe change in status of person-perceived participation restriction over three years in community-dwelling adults aged 50 years and over.</p> <p>Method</p> <p>Prospective cohort study (baseline and 3-year follow-up) using postal questionnaires mailed to a population-based sample of older adults. Responders were included in this study if they completed all items of the Keele Assessment of Participation at baseline (n = 6965). Estimates of onset and persistence of person-perceived participation restriction at 3-year follow-up were calculated for any and for each aspect of life in the sample as a whole, and then by age and gender using attrition re-weighted logistic regression to take account of sample attrition.</p> <p>Results</p> <p>In the whole sample of 6965 persons, overall participation status at three years was unchanged in 69%, and changed in 31%. Of 3431 persons with no restriction at baseline, it is estimated that 29.8% (95% confidence interval: 27.6%, 32.0%) would report restriction in at least one aspect of life at 3-year follow-up. Of 3534 persons who had baseline restriction, it is estimated that 68.8% (66.2%, 71.3%) would report continuing restriction in at least one aspect of life after 3 years. Onset and persistence both increased with age, and were most frequently recorded for restricted mobility outside the home.</p> <p>Conclusion</p> <p>Although most older persons do not change their overall participation status during a three-year period, change does occur which implies that population approaches to improving participation can be sought. Both onset and persistence of person-perceived participation restriction are more common the older the age-group.</p

Spatially distributed runoff at the grounding line of a large Greenlandic tidewater glacier inferred from plume modelling

Understanding the drivers of recent change at Greenlandic tidewater glaciers is of great importance if we are to predict how these glaciers will respond to climatic warming. A poorly constrained component of tidewater glacier processes is the near-terminus subglacial hydrology. Here we present a novel method for constraining near-terminus subglacial hydrology with application to marine-terminating Kangiata Nunata Sermia in South-west Greenland. By simulating proglacial plume dynamics using buoyant plume theory and a general circulation model, we assess the critical subglacial discharge, if delivered through a single compact channel, required to generate a plume that reaches the fjord surface. We then compare catchment runoff to a time series of plume visibility acquired from a time-lapse camera. We identify extended periods throughout the 2009 melt season where catchment runoff significantly exceeds the discharge required for a plume to reach the fjord surface, yet we observe no plume. We attribute these observations to spatial spreading of runoff across the grounding line. Persistent distributed drainage near the terminus would lead to more spatially homogeneous submarine melting and may promote more rapid basal sliding during warmer summers, potentially providing a mechanism independent of ocean forcing for increases in atmospheric temperature to drive tidewater glacier acceleration

Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults

Objective: Evidence for effective management of shoulder impingement is limited. The present study aimed to quantify the clinical, neurophysiological, and biomechanical effects of a scapular motor control retraining for young individuals with shoulder impingement signs.Method: Sixteen adults with shoulder impingement signs (mean age 22 ? 1.6 years) underwent the intervention and 16 healthy participants (24.8 ? 3.1years) provided reference data. Shoulder function and pain were assessed using the Shoulder Pain and Disability Index (SPADI) and other questionnaires. Electromyography (EMG) and 3 dimensional motion analysis was used to record muscle activation and kinematic data during arm elevation to 90? and lowering in 3 planes. Patients were assessed pre and post a 10-week motor control based intervention, utilizing scapular orientation retraining.Results: Pre-intervention, patients reported pain and reduced function compared to the healthy participants (SPADI in patients 20 ? 9.2; healthy 0 ? 0). Post intervention, the SPADI scores reduced significantly (P &lt; .001) by a mean of 10 points (?4). EMG showed delayed onset and early termination of serratus anterior and lower trapezius muscle activity pre-intervention, which improved significantly post-intervention (P &lt; .05). Pre intervention, patients exhibited on average 4.6-7.4? less posterior tilt, which was significantly lower in 2 arm elevation planes (P &lt; .05) than healthy participants. Postintervention, upward rotation and posterior tilt increased significantly (P &lt;.05) during 2 arm movements, approaching the healthy values.Conclusion: A 10-week motor control intervention for shoulder impingement increased function and reduced pain. Recovery mechanisms were indicated by changes in muscle recruitment andscapular kinematics. The efficacy of the intervention requires further examined in a randomizedcontrol trial

Towards quantifying the glacial runoff signal in the freshwater input to Tyrolerfjord–Young Sound, NE Greenland

Terrestrial freshwater runoff strongly influences physical and biogeochemical processes at the fjord scale and can have global impacts when considered at the Greenland scale. We investigate the performance of the HIRHAM5 regional climate model over the catchments delivering freshwater to Tyrolerfjord and Young Sound by comparing to the unique Greenland Ecological Monitoring database of in situ observations from this region. Based on these findings, we estimate and discuss the fraction of runoff originating from glacierized and non-glacierized land delivered at the daily scale between 1996 and 2008. We find that glaciers contributed on average 50–80% of annual terrestrial runoff when considering different sections of Tyrolerfjord–Young Sound, but snowpack depletion on land and consequently runoff happens about one month earlier in the model than observed in the field. The temporal shift in the model is a likely explanation why summer surface salinity in the inner fjord did not correlate to modelled runoff. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13280-016-0876-4) contains supplementary material, which is available to authorized users

EIP-AGRI Focus Group : Precision farming

Final report201

B7-H4 expression identifies a novel suppressive macrophage population in human ovarian carcinoma

Tumor-associated macrophages are a prominent component of ovarian cancer stroma and contribute to tumor progression. B7-H4 is a recently identified B7 family molecule. We show that primary ovarian tumor cells express intracellular B7-H4, whereas a fraction of tumor macrophages expresses surface B7-H4. B7-H4+ tumor macrophages, but not primary ovarian tumor cells, suppress tumor-associated antigen-specific T cell immunity. Blocking B7-H4-, but not arginase-, inducible nitric oxide synthase or B7-H1 restored the T cell stimulating capacity of the macrophages and contributes to tumor regression in vivo. Interleukin (IL)-6 and IL-10 are found in high concentrations in the tumor microenvironment. These cytokines stimulate macrophage B7-H4 expression. In contrast, granulocyte/macrophage colony-stimulating factor and IL-4, which are limited in the tumor microenvironment, inhibit B7-H4 expression. Ectopic expression of B7-H4 makes normal macrophages suppressive. Thus, B7-H4+ tumor macrophages constitute a novel suppressor cell population in ovarian cancer. B7-H4 expression represents a critical checkpoint in determining host responses to dysfunctional cytokines in ovarian cancer. Blocking B7-H4 or depleting B7-H4+ tumor macrophages may represent novel strategies to enhance T cell tumor immunity in cancer