338 research outputs found

    Ability of Functional Performance Tests to Identify Individuals With Chronic Ankle Instability: A Systematic Review With Meta-Analysis

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    Objective: The purpose of this systematic review with meta-analysis was to determine the effectiveness of functional performance tests (FPTs) in differentiating between individuals with chronic ankle instability (CAI) and healthy controls. Data Sources: The National Library of Medicine Catalog (PubMed), the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and the SPORTDiscus, from inception to June 2017 were searched. Search terms consisted of: ā€œFunctional Performance Test*ā€ OR ā€œDynamic Balance Test*ā€ OR ā€œPostural Stability Test*ā€ OR ā€œStar Excursion Balance Test*ā€ OR ā€œHop Test*ā€ AND ā€œAnkle Instabilityā€ OR ā€œAnkle Sprain.ā€ Included articles assessed differences in FPTs in patients with CAI compared with a control group. Main Results: Included studies were assessed for methodological quality and level of evidence. Individual and mean effect sizes were also calculated for FPTs from the included articles. Twenty-nine studies met the criteria and were analyzed. The most common FPTs were timed-hop tests, side-hop, multiple-hop test, single-hop for distance, foot-lift test, and the Star Excursion Balance Tests (SEBTs). The side-hop (g = āˆ’1.056, P = 0.009, n = 7), timed-hop tests (g = āˆ’0.958, P = 0.002, n = 9), multiple-hop test (g = 1.399, P \u3c 0.001, n = 3), and foot-lift tests (g = āˆ’0.761, P = 0.020, n = 3) demonstrated the best utility with large mean effect sizes, whereas the SEBT anteromedial (g = 0.326, P = 0.022, n = 7), medial (g = 0.369, P = 0.006, n = 7), and posteromedial (g = 0.374, P \u3c 0.001, n = 13) directions had moderate effects. Conclusions: The side-hop, timed-hopping, multiple-hop, and foot-lift seem the best FPTs to evaluate individuals with CAI. There was a large degree of heterogeneity and inconsistent reporting, potentially limiting the clinical implementation of these FPTs. These tests are cheap, effective, alternatives compared with instrumented measures

    Rapid assessment of drug use and sexual HIV risk patterns among vulnerable drugusing populations in Cape Town, Durban and Pretoria, South Africa

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    This exploratory study examines the links between drug use and high-risk sexual practices and HIV in vulnerable drug-using populations in South Africa, including commercial sex workers (CSWs), men who have sex with men (MSM), injecting drug users (IDUs) and non-injecting drug users who are not CSWs or MSM (NIDUs). A rapid assessment ethnographic study was undertaken using observation, mapping, key informant interviews and focus groups in known ā€˜hotspots\' for drug use and sexual risk in Cape Town, Durban and Pretoria. Key informant (KI) and focus group interviews involved drug users and service providers. Purposeful snowball sampling and street intercepts were used to recruit drug users. Outcome measures included drug-related sexual HIV risk behaviour, and risk behaviour related to injection drug use, as well as issues relate to service use. HIV testing of drug-using KIs was conducted using the SmartCheck Rapid HIV-1 Antibody Test. Non-injection drug use (mainly cannabis, methaqualone, crack cocaine and crystal methamphetamine) and injection drug use (mainly heroin) was occurring in these cities. Drug users report selling sex for money to buy drugs, and CSWs used drugs before, during and after sex. Most (70%) of the drug-using KIs offered HIV testing accepted and 28% were positive, with rates highest among CSWs and MSM. IDUs reported engaging in needle sharing and needle disposal practices that put them and others at risk for contracting HIV. There was a widespread lack of awareness about where to access HIV treatment and preventive services, and numerous barriers to accessing appropriate HIV and drug- intervention services were reported. Multiple risk behaviours of vulnerable populations and lack of access to HIV prevention services could accelerate the diffusion of HIV. Targeted interventions could play an important role in limiting the spread of HIV in and through these under-reached and vulnerable populations. Keywords: Drug use, sexual risk behaviour, HIV/AIDS, South Africa.SAHARA-J Vol. 5 (3) 2008: pp. 113-11

    LOWER LEG MORPHOLOGY AND STRETCH-SHORTENING CYCLE PERFORMANCE IN YOUNG AND ELDERLY MALES

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    The purpose of this investigation was to examine bone and muscle characteristics of the lower leg and stretch-shortening cycle capabilities of the ankle in young (22.3 Ā± 1.3 yrs) and elderly (67.5 Ā± 3.3 yrs) males. Peripheral quantitiative computed tomography (pQCT) was utilized to assess bone stress-strain index, bone ultimate fracture load, muscle density, muscle cross-sectional area (CSA), fat CSA and muscle+bone CSA. Maximal voluntary isometric plantarflexion (MVIP) force and force-velocity measurments during a countermovement hop (CMH) and drop hops from 20, 30 and 40 cm (DH20, DH30, DH40) were also measured. Bone stress-strain index was significantly higher in young males as well as muscle density, muscle CSA and muscle+bone CSA in comparison to elderly males. MVIP peak force and rate of force development was significantly higher in young males in comparsion to elderly males as well. An analysis of the force-velocity curves indicated that young males had significanlty higher levels of force and velocity in both the eccentric and concentric phase during the CMH, DH20, DH30 and DH40 in comparsion to elderly males. The data from this investigation indicate that aging potentially negatively influences lower leg bone and muscle strength and this may be reflected in lower stretch-shortening cycle capabilities of the ankle

    FORCE-VELOCITY PROFILES OF DANCERS AND ENDURANCE RUNNERS DURING ANKLE-SPECIFIC STRETCH-SHORTENING CYCLE TASKS

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    While dance and endurance running drastically differ from one another in an anecdotal context, both modalities of movement necessitate proficient stretch-shortening cycle (SSC) function about the ankle-joint. The purpose of the present study was to compare force-velocity profiles in dancers (n=6) and endurance runners (n=6) during a countermovement hop (CMH) and 30 cm drop hop (DH30) to elucidate differences between groups that would potentially stimulate effective training regimens. Average relative force-time, velocity-time and force-velocity curves were generated for each groupā€™s CMH and DH30. Dancers hopped significantly higher (p ā‰¤ 0.05) than endurance runners in both hopping tasks. Data from this investigation indicate that dancers and runners have distinctive temporal patterns and force production characteristics during ankle-joint SSC tasks with respect to the eccentric and concentric phase. This may be due to the unique SSC characteristics of each groupā€™s corresponding training protocols

    Cardioprotection by systemic dosing of thymosin beta four following ischemic myocardial injury

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    Thymosin beta 4 (TĪ²4) was previously shown to reduce infarct size and improve contractile performance in chronic myocardial ischemic injury via two phases of action: an acute phase, just after injury, when TĪ²4 preserves ischemic myocardium via antiapoptotic or anti-inflammatory mechanisms; and a chronic phase, when TĪ²4 activates the growth of vascular or cardiac progenitor cells. In order to differentiate between the effects of TĪ²4 during the acute and during the chronic phases, and also in order to obtain detailed hemodynamic and biomarker data on the effects of TĪ²4 treatment suitable for use in clinical studies, we tested TĪ²4 in a rat model of chronic myocardial ischemia using two dosing regimens: short term dosing (TĪ²4 administered only during the first 3 days following injury), and long term dosing (TĪ²4 administered during the first 3 days following injury and also every third day until the end of the study). TĪ²4 administered throughout the study reduced infarct size and resulted in significant improvements in hemodynamic performance; however, chamber volumes and ejection fractions were not significantly improved. TĪ²4 administered only during the first 3 days following injury tended to reduce infarct size, chamber volumes and improve hemodynamic performance. Plasma biomarkers of myocyte injury were significantly reduced by TĪ²4 treatment during the acute injury period, and plasma ANP levels were significantly reduced in both dosing groups. Surprisingly, neither acute nor chronic TĪ²4 treatment significantly increased blood vessel density in peri-infarct regions. These results suggest the following: repeated dosing may be required to achieve clinically measureable improvements in cardiac function post-myocardial infarction (MI); improvement in cardiac function may be observed in the absence of a high degree of angiogenesis; and that plasma biomarkers of cardiac function and myocardial injury are sensitive pharmacodynamic biomarkers of the effects of TĪ²4

    Implementation, adoption and perceptions of telemental health during the COVID-19 pandemic: a systematic review

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    BACKGROUND: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health, and to debates on its future use in routine mental health care. OBJECTIVE: To investigate the adoption and impacts of telemental health approaches during the COVID-19 Pandemic, and facilitators and barriers to optimal implementation. METHODS: Four databases (PubMed, PsycINFO, CINAHL and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesised using framework synthesis. RESULTS: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. CONCLUSIONS: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these. CLINICALTRIAL

    Treatment of non-small cell lung cancer with intensity-modulated radiation therapy in combination with cetuximab: the NEAR protocol (NCT00115518)

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    BACKGROUND: Even today, treatment of Stage III NSCLC still poses a serious challenge. So far, surgical resection is the treatment of choice. Patients whose tumour is not resectable or who are unfit to undergo surgery are usually referred to a combined radio-chemotherapy. However, combined radio-chemotherapeutic treatment is also associated with sometimes marked side effects but has been shown to be more efficient than radiation therapy alone. Nevertheless, there is a significant subset of patients whose overall condition does not permit administration of chemotherapy in a combined-modality treatment. It could be demonstrated though, that NSCLCs often exhibit over-expression of EGF-receptors hence providing an excellent target for the monoclonal EGFR-antagonist cetuximab (Erbitux(Ā®)) which has already been shown to be effective in colorectal as well as head-and-neck tumours with comparatively mild side-effects. METHODS/DESIGN: The NEAR trial is a prospective phase II feasibility study combining a monoclonal EGF-receptor antibody with loco-regional irradiation in patients with stage III NSCLC. This trial aims at testing the combination's efficacy and rate of development of distant metastases with an accrual of 30 patients. Patients receive weekly infusions of cetuximab (Erbitux(Ā®)) plus loco-regional radiation therapy as intensity-modulated radiation therapy. After conclusion of radiation treatment patients continue to receive weekly cetuximab for 13 more cycles. DISCUSSION: The primary objective of the NEAR trial is to evaluate toxicities and feasibility of the combined treatment with cetuximab (Erbitux(Ā®)) and IMRT loco-regional irradiation. Secondary objectives are remission rates, 3-year-survival and local/systemic progression-free survival

    Methamphetamine and Viagra Use: Relationship to Sexual Risk Behaviors

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    Recent studies show that Viagra and methamphetamine use are associated with unprotected anal intercourse among men who have sex with men (MSM). In Long Beach, California, we have reported on an association between Viagra use and the use of amphetamines during sex. The current research investigated the use of both Viagra and amphetamine in men in Long Beach, California. Data on 1,839 men recruited into HIV prevention and testing programs were collected using the Risk Behavior Assessment. A generalized logit model was constructed comparing ever having used both amphetamine and Viagra together and separately, as compared to never having used either (referent). Men who used both methamphetamine and Viagra showed a significantly higher prevalence of hepatitis B, syphilis, and HIV compared to those who used only one or neither drug. Of the 1,794 complete cases, 11.1% (199/1794) had used both amphetamine and Viagra. Of 20 potential risk and protective factors for use of amphetamine and Viagra, 12 were significant predictors: ever used gamma-hydroxybutyrate (GHB), ever used cocaine, ever used ecstasy, being infected with HIV, raceĀ =Ā White compared to other, ever having hepatitis B, ever using crack, ever given money to have sex, living in a hotel, ever been in drug treatment, and ever using heroin. The protective factor was being heterosexual. Viagra use was associated with insertive, and methamphetamine was associated with receptive, anal intercourse. GHB use appears to play a more important role than previously thought
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