Proximal Strength and Functional Testing Applicable to Patellofemoral Instability: A Preliminary Study

Background: Much of the current literature around risk factors for patellar instability directs attention to anatomical/structural features such as femoral antero-version, patellar alignment, Q-angle, and MPFL disruption. There is limited research indicating clinically relevant tests to identify functional and strength-associated risk factors for patients with patellar instability. Purpose: To determine reliability and validity of lower extremity functional tests applicable to patients with patellofemoral instability in a healthy control group. Methods: Twenty-four healthy subjects underwent hip strength, endurance, and lower extremity functional tests on their dominant and non-dominant lower extremities. Hip abduction, extension, and external rotation strength were assessed with hand-held dynamometry utilizing reinforcing straps. Functional endurance tests were assessed bilaterally. Functional assessments were videotaped and assessed at a later date. Each subject completed the International Physical Activity Questionnaire (IPAQ) to determine his or her weekly activity levels. Independent t-tests were used to assess differences between subjects who tested positive versus negative on the functional tests. Inter-rater reliability for functional tests was assessed using kappa and Pearson correlations were used to assess relationships among the strength, endurance, and functional tests. Results: Inter-rater reliability for the single leg squat and step down test was determined to have fair-moderate agreement among 5 raters. The side plank endurance test was significantly lower for subjects who were positive for knee medial to toe on the single leg squat test. Low correlations were found between hip strength and functional endurance testing. Scores on the IPAQ had moderate correlation with the side plank. Conclusions: Single leg squat showed adequate reliability and demonstrated good construct validity with the lateral plank endurance test. The low correlation between hip strength and functional endurance suggests that these measurements identify different aspects of muscle function in healthy controls. Given these findings, it is recommended that clinicians utilize both strength measurements and endurance tests along with lower extremity functional testing in the assessment of individuals with lower extremity dysfunction. Further testing is needed in a patient population with patellofemoral instability

Marshall University Music Department Presents the Marshall University Symphony Orchestra, Concert of Soloists. Dr. Elizabeth Reed Smith, conductor, with, William H. Holderby II, horn, Brianna Williams, euphonium, Mary Beth Withers, soprano

https://mds.marshall.edu/music_perf/1446/thumbnail.jp

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Bee Sugar: a sweet take on the music of soul & Bee Spice: a tale of a single bee

Concert I “Bee Sugar: a sweet take on the music of soul” Set List: Because He Lives (Traditional hymn) Spring Can Really Hang You Up The Most (Tom Wolf/Fran Landsman) Ode to Nikki (Brianna Reed/poem by Nikki Giovanni) When a Woman Loves a Man (Billie Holiday) In the Midst of It All (Yolanda Adams/Kevin Bond) Bee’s Lament (Brianna Reed) Call Me (Aretha Franklin) My first concert, “Bee Sugar, “ is a tribute to my musical history. It explores the humble beginnings of my love affair with music. I chose songs from genres of music I grew up listening to: gospel, jazz and classic soul. My inspiration and muse was my mother. She has been an important factor in my decisions as a musician and has motivated me to continue pursuing a life in music. All of the music I love comes from growing up in a household where there were constant melodies, harmonies, and thoughtful lyrics floating in the air. I originally planned to only sing songs that were by other musicians but I was inspired by my peers and advisor to compose my own songs. I wrote two songs entitled “Ode to Nikki” and “Bee’s Lament.” “Ode to Nikki” developed from my love of poet, Nikki Giovanni’s works. I used her poem A Poem of Friendship as the lyric to the song. I wanted every song to evoke an emotion from each audience member, hoping to welcome them into experiences and the history of my musical journey. Concert II “Bee Spice: a tale of a single bee” Set List: Bee’s Lament Redux (Brianna Reed) So Glad (Joseph Tisdall, Brianna Reed) Notice (Brianna Reed) You Got Me (Brianna Reed) BFF (Brianna Reed, arr. Zachary Seman) Just Sex (Brianna Reed, Zachary Seman) Show &Tell (Joseph Tisdall, Brianna Reed) So Fast (Brianna Reed) When I meet the love of my life I hope I recognize him and he sees me and we both catch the glimmer in each other’s eye and notice the familiarity. That we become friends first and are confident in finding the missing piece of ourselves. That each word we share is truth and loyalty. Support and motivation. Love and forgiveness. I have yet to find this love and if I do know him this just means I do not completely know myself enough to recognize that glimmer in his eyes. Preparing for this senior project could only be done by living life. I had to experience joy, pain, love and heartbreak. I needed to have late nights out with friends and moments in solitude. Spontaneous lyric and poetry were summoned from my sub-conscience begging to be liberated through melodies and rhythms. The majority of my lyric topics stem from personal experiences exploring every emotion felt from either individual or collective memories. They tell the stories, including pain and joy, but always hopeful. I strived to inspire the audience as well as myself. A lot of the inspirational songs were conversations to myself that I knew would be relatable to others as well

ÉMOTIONS POSITIVES ET RÉSILIENCE : EFFETS DES ÉMOTIONS POSITIVES SUR LE BIEN-ÊTRE PHYSIQUE ET PSYCHOLOGIQUE

L’article présente la théorie de Fredrickson sur les émotions positives dite « expansion et construction » (broaden and build) ainsi que des résultats qui la soutiennent. Dans le contexte de cette théorie, nous discutons des bienfaits de l’expansion et de la construction des émotions positives sur la santé physique et psychologique : une résilience aguerrie, des stratégies efficaces face au stress ainsi que la récupération physiologique à la suite d’expériences négatives. Enfin, nous présentons un bref aperçu des approches passées et actuelles pour l’étude des émotions positives et nous proposons de nouvelles techniques pour la mesure de ces émotions en utilisant les nouvelles technologies mobiles.In this paper, we review Fredrickson’s Broaden and Build theory of positive emotions and the empirical work supporting this theory. Within this context we discuss the beneficial psychological and physical health outcomes associated with the broadening and building effects of positive emotions, such as greater resilience and coping in the face of stress as well as physiological recovery after negative experiences. Lastly, this paper will outline past and current approaches to studying positive emotions, and will propose new methods of measuring positive emotion by using modern, mobile technology

Interpersonal emotion regulation in betrayal trauma survivors: A preliminary qualitative exploration

Interpersonal trauma, or trauma involving maltreatment by someone that a survivor has a close, personal relationship with (i.e., betrayal trauma), may be particularly predictive of alterations in interpersonal and emotion regulation processes. Social support may facilitate interpersonal emotion regulation (IER) and posttraumatic functioning, though this process may be particularly difficult for survivors of betrayal trauma. The current study includes a sample of female-identifying betrayal trauma survivors with clinically significant PTSD symptomology (N = 70). Thematic analysis was utilized to investigate how these survivors describe their affective experience and the factors that impact their willingness and comfort to engage with others during times of distress. Most participants were able to describe their emotional experiences, but provided brief, simplistic descriptions. Generally, participants reported feeling wary of sharing negative emotions with others due to fear of judgment or being seen as a burden. Findings allow us to better understand how survivors make sense of and differentiate their emotions, and their experienced benefits of or barriers to IER