On the genesis of bipedalism

Abstract of paper presented at the 5th SASQUA Conference, July 1979Bipedalism is the hallmark of the Hominidae, past and present. Only against this fundamental adaptive background could cerebral, dental and manual modifications develop to change ape into ape-man, and ape-man into man. Yet surprisingly little is known of its origin, of the variety of forms of locomotor behaviour it has encompassed, or about the sequence of postural refinements which has led to our modern pattern of stance and gait. In an attempt to trace the Plio-Pleistocene history of two-footedness, lower limb fossils of early hominids are examined here. South and East African sites are covered, with special reference to the period 3,6 to 1 ,5 My ago. Numerous structural challenges had to be met so that uprightness could evolve successfully. Several are considered of special interest here, including sacroiliac joint consolidation, a lumbo-acetabular weight transfer mechanism, acetabular remodelling and femorotibial alignment. These features have contributed to the attainment of balance over two limbs, minimal eccentric joint movements and a flow of body weight close to or through joint centres. A primary palaeoanthropological question is then discussed: the time period during which cladogenesis brought about the emergence of earliest Homo from an Australopithecus stock. Lower limb evidence is used to evaluate whether A. africanus postdated this split, and in so doing the possibility is considered that southern African australopithecines exhibited parallel evolution to Homo, rather than having been ancestral. Finally, comparisons are drawn between certain East and South African features of pelvic and lower limb evolution. A chronology of osseous aspects of such evolution is proposed.Non

Xanthoma Tendinosum

A CAJM article on Xanthoma Tendinosum.The formation of xanthomata in tendons occurs typically as part of a familial disorder associated with an elevation of the total plasma cholesterol. In those cases where the tendinous deposits are small in size and few in number, the cholesterol level is usually only moderately raised, extensive deposits being more commonly associated with much higher levels. It is therefore of interest to have encountered a patient with a severe degree of xanthoma tendinosum whose plasma cholesterol was in the normal range

The development of a geriatric postgraduate education assessment instrument using a modified Delphi procedure

There is currently wide variation in the structure and content of higher medical training in geriatric medicine across Europe and no common framework within which existing efforts can be compared. We set out to develop an audit tool to compare training between countries. An initial review of indexed and grey literature was used to develop an audit tool which was used as the basis of an Internet-based modified Delphi process incorporating the views of 14 expert geriatricians from across Europe. Items in the audit tool were included or excluded when supported by ≥75% or <50% of respondents, respectively. Items supported by 50–74% of respondents were carried forward with additional suggestions and modifications included following Round 1. Thirteen experts representing 12 countries responded to both rounds. 40/45 items were supported at Round 1. Five items were carried forward. A further 13 elements were introduced for consideration at Round 2. Consensus was gained after the second round. The final tool describes 52 items across four domains: general considerations, topics referring to knowledge in patient care, different roles that should be considered in medical training and topics regarding assessment. The resulting tool can be used as a basis for comparing higher medical training programmes in geriatric medicine between countries. Individual countries can use this to audit current practice. At an European Union level, the insights gained through such audit will form the basis of future work to develop an agreed postgraduate curriculum in the specialty

Liver injury is most commonly due to hepatic metastases rather than drug hepatotoxicity during pembrolizumab immunotherapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151912/1/apt15413-sup-0001-FigS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151912/2/apt15413.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151912/3/apt15413_am.pd

Cumulative Load of Depressive Symptoms Is Associated With Cortisol Awakening Response in Very Old Age.

This study examined links of cumulative and present depressive symptoms with present cortisol diurnal profiles in oldest-old adults. Five waves of data from 50 older adults (M age = 89.05 years; 64% women) who participated in the Australian Longitudinal Study of Ageing were used to combine 15 years of longitudinal data with seven cortisol samples per day over a one-week period. Findings revealed that individuals with more past depressive symptoms showed a lower cortisol awakening response (CAR). Interestingly, present depressive symptoms were not associated with the CAR. These findings inform our understanding of distal health factors in very old age

Firming up institutional policy for deprived elderly in Cameroon

In a context of deepening poverty, policy realignment is crucial in tackling deficits in social security provision for Cameroon's growing elderly population. Tackling deficiencies is undermined by institutional failings, a dysfunctional bureaucracy, and a policy process characterized by dithering rather than concrete action. This article uncovers an impasse linked to the inability of existing institutional frameworks to confront the aging problematic. Empirical data point to elderly agency and a range of resources to fill the gaps left by state retreat. Institutional strengthening and social capital theory resonate here. A triangular policy framework reveals intricacies of coping via individual, family, and mutuality, explicating cardinal administrative roles. I suggest the design and delivery of social welfare provision should concentrate on institutional strengthening, improving architecture, and the workings of ministerial departments. Embedding a people-oriented bureaucracy and delivering targeted social assistance can serve as useful paradigms in policy revamps for the deprived elderly