Nutritional, pasting and sensory properties of a weaning food from rice (Oryza sativa), soybeans (Glycine Max) and kent Mango (Mangifera indica) flour blends

The effective use of readily available and inexpensive sources of protein and micronutrients has become a major focus of research in recent years. This study sought to provide a nutritionally adequate and culturally acceptable weaning food for infants, as well as tap the potential of broken rice fraction as an alternative use for weaning formulation in Ghana. Flour from broken rice fractions in combination with soybeans and dried mangoes were used to develop four weaning formulations. Rice-Soy Mango (RSM) was prepared with 75% rice flour, 25% soybeans flours and 0% mango flour (RSM-0), and used as control; RSM-5 was prepared with 70% rice flour, 25% soybeans flours and 5% mango flour; RSM-10 was prepared with 65% rice flour, 25% soybeans flours and 10% mango flour while RSM-15 was prepared with 60% rice flour, 25% soybeans flours and 15% mango flour. The products were evaluated for their nutritional composition, sensory characteristics and pasting properties. All the three newly formulated rice-mango weaning food met the Estimated Average Requirement (EAR) for energy (393.71-403.25 KCal/100 g), protein (10.7-15.24 g/100 g), carbohydrates (68.44-73.87g/100 g), zinc (8.67-10.84 mg/d and vitamin C (13.96-17.79 mg/100 g) levels but not for iron (3.99-7.61 mg/100 g), fat (6.22-7.61 g/100 g) and calcium (87.2-111.7 mg/100 g). The beta-carotene levels ranged from 74.8 to 346.6 μg/100 g and showed significant differences. The pasting profile for the blends with low amounts of mango (RSM-5 and RSM-10) had a similar profile as the control (RSM-0), while RSM-15 had a lower profile. Among the three newly formulated blends, RSM-10 had the highest peak viscosity (74.0 BU) and highest final viscosity of 107 BU. The RSM-5, RSM-10 and RSM-15 were all lighter than RSM-0, albeit not significant. Increasing the content of mango resulted in the flour blend becoming more yellow. Even though the sensory quality of RSM-5 was the most preferred, there was no significant difference (p>0.05) observed between the sensory quality of all the three newly formulated products (RSM-5, RSM-10, RSM-15). The RSM-10 showed great potential and may be recommended and adopted for promotion within Ghanaian households based on its high nutritional and good sensory qualities.Key words: Weaning, Broken Rice, Mangoes, Pasting, Sensory, Vitamin A, Iron, Childre

Patient-Reported, Not Performance Based, Outcome Measures Are Correlated With Future Falls in Community Dwelling Older Adults

Background: One-third of community-dwelling older adults fall at least once a year, yet many commonly used performance-based outcome measures for falls have ceiling effects. Additionally, psychological factors such as fear of falling and avoidance behaviors may contribute to fall risk. Purpose: To determine whether balance confidence, fear of falling avoidance behaviors, or performance on high-level mobility outcome measures can predict falls in community-dwelling older adults. Methods: Eighty-nine participants (76 ± 7 years) completed the Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behaviors Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance & Mobility Scale (CB&M) and then recorded their falls for 6 months. Spearman’s rho, a Point-Biserial Correlation, and Receiver Operating Curves were used to analyze the relationship of the selected outcome measures, past falls, and future falls. Results: There were statistically significant correlations between falls and both the ABC (r2=-.235, p=.022) and the FFABQ (r2=.286, p=.019). There was a positive correlation between history of falls and future falls (r=.323, p=.002). The ABC (area under curve [AUC] =.632, p=.038) and the FFABQ (AUC=.655, p=.015) were significant predictors of future falls. The optimal cutoff scores for determining individuals who experienced falls were: ABC-96% (79% sensitivity, 66% specificity) and FFABQ-1.50 (79%, 55%). Conclusion: No single outcome measure was found to be strongly correlated with falls. The ABC, FFABQ, and history of falls were weakly correlated with future falls. A cutoff score of 96% on the ABC and 1.50 on the FFABQ had adequate sensitivity, but low specificity for predicting falls

To Sport Program After Lower Extremity Injury

Introduction 8.6 million sports and recreation related injury episode per year Inadequate rehabilitation and premature return to play identified as risk factors for multiple lower extremity injuries Objective Assess the effectiveness of a return to sport program established for patients with lower extremity injuries. Methods Outcome Measures: IKDC, TSK-11 Performance based tests for pre and post assessment: Single leg timed hop, triple crossover hop Results Statistically significant changes from pre- to post-ASCEND in: 6 meter single-leg timed hop, triple crossover hop, IKDC, TSK-11 Conclusion The ASCEND return to sport program elicits statistically significant change in single leg timed hop, triple crossover hop, IKDC, and TSK-11. Clinical Relevance A high density return to sport program can elicit change through agility, plyometrics, strength, core, and endurance training

Men\u27s Pelvic Health: Exploration of Entry-Level DPT Curricular Content Based on a National Faculty Survey

Introduction The pelvis and its floor play an integral role in everyday quality of life for both women and men. Survey research on women’s health content in Doctor of Physical Therapy (DPT) programs has helped develop curricular structure for entry-level therapists. Characteristics of content presented on men’s pelvic health (MPH) in DPT programs is unknown. 2019: The Section on Women’s Health voted to change their name to the Academy of Pelvic Health to be all inclusive. Objective To examine current entry-level content on MPH in DPT programs, perceived barriers to content delivery, and to support future entry-level curricular development. Participants Program directors or faculty responsible for pelvic health content at CAPTE accredited DPT programs across the United States. Methods Online surveys sent to 239 DPT programs nationally Questions based on literature review and Boissonault’s research. (likert scale, choose all, open-ended) Quantitative and qualitative data regarding MPH content collected: opinions, hours taught, topics covered, barriers, demographics Results Response rate: 23 percent (55 programs) 60.0 percent strongly agree that MPH should be taught in entry-level DPT programs. 23.6 percent reported spending less than 1 hour teaching men’s pelvic health content. 63.3 percent reported “time” as the largest barrier. Qualitative themes: men’s pelvic health curriculum, barriers, plans for inclusion of men’s pelvic health content. Sub-themes: lack of time in DPT curricula, faculty knowledge to instruct, viewed as a specialty PT, lack of curricular guidelines. Conclusions Basic MPH perceived as entry-level by participants and should be included in DPT curriculum. Lumbo-pelvic musculoskeletal dysfunction is a key component to evidence based practice. Male pelvis is an integral part of musculoskeletal dysfunction and perceived as important for entry-level identification and referral. MPH content delivery is inconsistent across programs. Barriers identified include: time constraints, experienced faculty, clinical importance. Clinical Relevance Male pelvic musculoskeletal dysfunction treatment is an entry-level skill. MPH curricular content can improve clinical awareness of pelvic health options for male patients, leading to higher quality recognition and referral. Improvement of care provided by entry-level physical therapists

Developing and Evaluating Teamwork Skills using an Interprofessional Simulated Discharge Planning Meeting

Purpose: The Clinical Discharge Scenario (CDS) provides students the opportunity to work as an interprofessional team in a simulated scenario. Evaluating student competence in teamwork skills provides insight into their ability to work as effective team members. Background: A literature review reveals the majority of tools assessing student learning in interprofessional education (IPE) measure satisfaction, attitudes and knowledge (Abu-Rish et al., 2012). Kirkpatrick’s evaluation model proposes a hierarchy of changes as a result of training (Kirkpatrick, 1979). At the highest level is transfer of learning to change behavior. Assessment of IPE influenced behavior change is limited (Abu-Rish et al., 2012). Description of Intervention: Interprofessional student teams participate in a simulated discharge planning meeting with an elder female patient and her adult daughter (standardized patients). Student teams develop a discharge plan for the patient. Teamwork is assessed via Team Observation checklists (Herge, et al, 2015) completed by faculty observers and standardized patients. Students debrief with faculty and standardized patients and complete a posttest identifying one thing they learned from the experience. Results: Three years of data spring 2014-2016 was analyzed. Preliminary results indicate students were rated as above average on team skills. Thematic analysis of the posttest revealed 7 themes: communication, client centered care, meeting structure, IPE teams, family/caregiver, student experience and difficult patient. Conclusion: The CDS is an effective way for students to practice teamwork skills in a simulated environment. Evaluating student behavior in this setting provides data regarding student ability to apply learning and demonstrate teamwork skills. Relevance to Interprofessional Education: The Institute of Medicine report (IOM, 2015) calls for greater measurement of IPE impact on practice and behavior change. Simulated patient encounters provide students the opportunity to practice teamwork skills and faculty to measure student teamwork skills as related to IPE. Learning Objectives: At the conclusion of this session participants will: Recognize the value of simulated learning activities in interprofessional education. Describe the learning outcomes of an interprofessional simulated team activity. Identify ways to evaluate performance as an outcome of interprofessional education in their own educational/clinical setting. References: 1. Abu-Rish, E., Kim, S., Choe, L., Varpio, L., Malik, E., White, A. A. & Thigpen, A. (2012). Current trends in interprofessional education of health sciences students: A literature review. Journal of Interprofessional Care, 26(6):444-451. 2. Kirkpatrick, D. L., (1979). Techniques for evaluating training programs. Training and Development Journal. 33(6):178-192. 3. Herge, E. A., Hsieh, C., Waddell-Terry, T. & Keats, P. (2015). A simulated clinical skills scenario to teach interprofessional teamwork to health profession students. Journal of Medical Education and Curricular Development. 2:27-34. doi:10.4137/JMECD.S18928 4. Institute of Medicine (2015). Measuring the impact of interprofessional education on collaboration and patient outcomes. Washington, D.C.: The National Academies Press

SILAC-based quantitative proteomic analysis of Drosophila gastrula stage embryos mutant for fibroblast growth factor signalling

Quantitative proteomic analyses in combination with genetics provide powerful tools in developmental cell signalling research. Drosophila melanogaster is one of the most widely used genetic models for studying development and disease. Here we combined quantitative proteomics with genetic selection to determine changes in the proteome upon depletion of Heartless (Htl) Fibroblast-Growth Factor (FGF) receptor signalling in Drosophila embryos at the gastrula stage. We present a robust, single generation SILAC (stable isotope labelling with amino acids in cell culture) protocol for labelling proteins in early embryos. For the selection of homozygously mutant embryos at the pre-gastrula stage, we developed an independent genetic marker. Our analyses detected quantitative changes in the global proteome of htl mutant embryos during gastrulation. We identified distinct classes of downregulated and upregulated proteins, and network analyses indicate functionally related groups of proteins in each class. In addition, we identified changes in the abundance of phosphopeptides. In summary, our quantitative proteomic analysis reveals global changes in metabolic, nucleoplasmic, cytoskeletal and transport proteins in htl mutant embryos

Evaluation of Short-Term Intensive Orthotic Garment Use in Children Who Have Cerebral Palsy

Purpose: To evaluate the effectiveness of an orthotic undergarment on gait, balance, and life skills of children who have diplegic cerebral palsy (CP). Methods: Five subjects (ages 7-13 years) with CP at Gross Motor Function Classification Scale level I wore a TheraTog™ undergarment for 12 weeks. Data collection included Vicon® Motion Analysis, Bruininks-Oseretsky Test of Motor Proficiency, and Canadian Occupational Performance Measure at baseline; in and out of the garment after 12 weeks of wear; 2 months and 4 months after garment wear. Results: Kinematic data indicated increased peak hip extension and correction of anterior pelvic tilt in stance during wear time

Men’s Pelvic Health Content in Entry-Level Doctor of Physical Therapy Curricula: A Physical Therapy Clinician Perspective

Introducation Pelvic floor musculature is involved in sexual, bowel, and bladder function, organ support, breathing, and load transfer.1 Sixteen percent of males experience pelvic floor dysfunction (PFD).1 Therefore, it is important for physical therapists to adequately screen male patients to identify PFD either for proper treatment or referral to a men’s pelvic health (MPH) provider. The Academy of Pelvic Health (APH) offers Doctor of Physical Therapy (DPT) curricular guidelines for Women’s Health content, but to date has no published guidelines for MPH. Objective The purpose of this study was to gain clinician perspective to assist in the development of DPT curricular guidelines for MPH content. Participants Licensed physical therapists on the mailing list of the APH. Methods A mixed-methods survey was distributed via email newsletter. Question formats included: yes/no, multiple choice, select all that apply, 5-point Likert scale, and open- ended response(s). Questions regarding the incorporation of, and barriers to, inclusion of MPH content in DPT curricula were included. Descriptive statistics and frequencies were calculated using various functions in Microsoft Excel®. Qualitative data from free response questions were coded and categorized into themes using a grounded theory methodology. Results A total of 203 survey responses were received for quantitative and qualitative data analysis. Student physical therapists and physical therapy assistants were excluded from participation. Conclusion The majority of survey participants agreed that inclusion of MPH education in entry-level DPT curricula is important and that it would be best delivered through a pelvic health course within the curriculum. Clinical Relevance The data received through this survey may be used to assist in the development of MPH curricular guidelines. DPT programs should implement further MPH content to prepare students for proper screening and treatment or referral of patients with PFD. By doing so, patients will receive the necessary treatment more quickly and may experience improved outcomes

Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines

New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p < 0.001). In Malawi, a pre/post study showed increases in HTS sites and tests after delegation to lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally

Surveillance of congenital Zika syndrome in England and Wales: methods and results of laboratory, obstetric and paediatric surveillance.

The spread of the Zika virus (ZIKV) in the Americas led to large outbreaks across the region and most of the Southern hemisphere. Of greatest concern were complications following acute infection during pregnancy. At the beginning of the outbreak, the risk to unborn babies and their clinical presentation was unclear. This report describes the methods and results of the UK surveillance response to assess the risk of ZIKV to children born to returning travellers. Established surveillance systems operating within the UK - the paediatric and obstetric surveillance units for rare diseases, and national laboratory monitoring - enabled rapid assessment of this emerging public health threat. A combined total of 11 women experiencing adverse pregnancy outcomes after possible ZIKV exposure were reported by the three surveillance systems; five miscarriages, two intrauterine deaths and four children with clinical presentations potentially associated with ZIKV infection. Sixteen women were diagnosed with ZIKV during pregnancy in the UK. Amongst the offspring of these women, there was unequivocal laboratory evidence of infection in only one child. In the UK, the number and risk of congenital ZIKV infection for travellers returning from ZIKV-affected countries is very small