Physiotherapy management of lower limb osteoarthritis

© The Author 2017. Published by Oxford University Press. Background Osteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition. Sources of data Evidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK. Areas of agreement There is strongest evidence to support the use of exercise to improve pain, function and quality of life. Areas of controversy There is limited evidence to support the use of some commonly utilized physiotherapy interventions. National Institute for Health and Clinical Excellence do not recommend the use of acupuncture. Growing points Programmes that include single exercise type may be more beneficial than combined strengthening and aerobic interventions. Areas timely for developing research Further research is required to determine how to facilitate long-term engagement with exercise to sustain the beneficial effects on pain, function and quality of life. Studies that investigate packages of care, combining interventions require further investigation

The FGF receptor uses the endocannabinoid signaling system to couple to an axonal growth response

Akey role for DAG lipase activity in the control of axonal growth and guidance in vitro and in vivo has been established. For example, DAG lipase activity is required for FGF-stimulated calcium influx into neuronal growth cones, and this response is both necessary and sufficient for an axonal growth response. The mechanism that couples the hydrolysis of DAG to the calcium response is not known. The initial hydrolysis of DAG at the sn-1 position (by DAG lipase) will generate 2-arachidonylglycerol, and this molecule is well established as an endogenous cannabinoid receptor agonist in the brain. In the present paper, we show that in rat cerebellar granule neurons, CB1 cannabinoid receptor antagonists inhibit axonal growth responses stimulated by N-cadherin and FGF2. Furthermore, three CB1 receptor agonists mimic the N-cadherin/FGF2 response at a step downstream from FGF receptor activation, but upstream from calcium influx into cells. In contrast, we could find no evidence for the CB1 receptor coupling the TrkB neurotrophin receptor to an axonal growth response in the same neurons. The observation that the CB1 receptor can couple the activated FGF receptor to an axonal growth response raises novel therapeutic opportunities

On the Dynamics of Laguerre’s Iteration Method for Finding the nth Roots of Unity

Previous analyses of Laguerre’s iteration method have provided results on the behavior of this popular method when applied to the polynomials () = − 1, ∈ N. In this paper, we summarize known analytical results and provide new results. In particular, we study symmetry properties of the Laguerre iteration function and clarify the dynamics of the method. We show analytically and demonstrate computationally that for each ≥ 5 the basin of attraction to the roots is a subset of an annulus that contains the unit circle and whose Lebesgue measure shrinks to zero as → ∞. We obtain a good estimate of the size of the bounding annulus. We show that the boundary of the basin of convergence exhibits fractal nature and quasi self-similarity. We also discuss the connectedness of the basin for large values of . We also numerically nd some short nite cycles on the boundary of the basin of convergence for = 5, ..., 8. Finally, we demonstrate that when using the oating point arithmetic and the general formulation of the method, convergence occurs even from starting values outside of the basin of convergence due to the loss of signi cance during the evaluation of the iteration function

Carbon Free Boston: Social equity report 2019

OVERVIEW: In January 2019, the Boston Green Ribbon Commission released its Carbon Free Boston: Summary Report, identifying potential options for the City of Boston to meet its goal of becoming carbon neutral by 2050. The report found that reaching carbon neutrality by 2050 requires three mutually-reinforcing strategies in key sectors: 1) deepen energy efficiency while reducing energy demand, 2) electrify activity to the fullest practical extent, and 3) use fuels and electricity that are 100 percent free of greenhouse gases (GHGs). The Summary Report detailed the ways in which these technical strategies will transform Boston’s physical infrastructure, including its buildings, energy supply, transportation, and waste management systems. The Summary Report also highlighted that it is how these strategies are designed and implemented that matter most in ensuring an effective and equitable transition to carbon neutrality. Equity concerns exist for every option the City has to reduce GHG emissions. The services provided by each sector are not experienced equally across Boston’s communities. Low-income families and families of color are more likely to live in residences that are in poor physical condition, leading to high utility bills, unsafe and unhealthy indoor environments, and high GHG emissions.1 Those same families face greater exposure to harmful outdoor air pollution compared to others. The access and reliability of public transportation is disproportionately worse in neighborhoods with large populations of people of color, and large swaths of vulnerable neighborhoods, from East Boston to Mattapan, do not have ready access to the city’s bike network. Income inequality is a growing national issue and is particularly acute in Boston, which consistently ranks among the highest US cities in regards to income disparities. With the release of Imagine Boston 2030, Mayor Walsh committed to make Boston more equitable, affordable, connected, and resilient. The Summary Report outlined the broad strokes of how action to reach carbon neutrality intersects with equity. A just transition to carbon neutrality improves environmental quality for all Bostonians, prioritizes socially vulnerable populations, seeks to redress current and past injustice, and creates economic and social opportunities for all. This Carbon Free Boston: Social Equity Report provides a deeper equity context for Carbon Free Boston as a whole, and for each strategy area, by demonstrating how inequitable and unjust the playing field is for socially vulnerable Bostonians and why equity must be integrated into policy design and implementation. This report summarizes the current landscape of climate action work for each strategy area and evaluates how it currently impacts inequity. Finally, this report provides guidance to the City and partners on how to do better; it lays out the attributes of an equitable approach to carbon neutrality, framed around three guiding principles: 1) plan carefully to avoid unintended consequences, 2) be intentional in design through a clear equity lens, and 3) practice inclusivity from start to finish

I am your trans patient

For the first time we are publishing a What Your Patient is Thinking article by a group of people. These transgender authors share their experiences of healthcare and the important messages they would like doctors to know

"Dos de todo": El cuento chino de los problemas de comparación multiplicativa en la Educación Infantil

Narración del desarrollo de dos sesiones de un taller de resolución de problemas con niños y niñas de 5 y 6 años, pertenecientes a dos grupos de Educación Infantil. Partiendo de la lectura del cuento chino “Doble de todo”, los pequeños abordan la resolución de dos problemas de comparación multiplicativa. Los niños, a través del uso de diversas estrategias informales de modelización directa, y empleando distintas representaciones manipulativas y gráficas de cantidades, llegan a las soluciones de los problemas y las comparten con sus compañeros. Esta experiencia forma parte de una investigación dirigida al desarrollo del currículo de la Educación Infantil

Using photography to voice young people's views about community and local service delivery

Youth offending has received significant attention in recent years in Queensland and across Australia. While the voices of young people who are offending or at risk of offending are evident in some studies, other reports do not identify them as key stakeholders. A recent university-industry research collaboration sought to prioritise the voices of young people engaging with The Lighthouse, a diversionary service within Townsville Aboriginal and Islander Heath Services (TAIHS), through use of qualitative, Photovoice methods. The primary aim of this photovoice project was to capture the perceptions and needs of young people currently at risk of offending, and to document those views to help shape local service delivery. A thematic analysis enabled the identification of four key themes. These themes identified that participants felt unsafe and under surveillance in public spaces; they wanted more amenities where they could enjoy being in the community with their peers; they reported that peers and family were very important to them; and they appreciated services on offer at The Lighthouse and acknowledged these services supported behavioural change. The findings provide a unique contribution to the use of creative research methodologies, and to policy and service delivery focused on young people at risk of offending

Treat-to-target in PsA: methods and necessity

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. With increasing recognition of the high burden and impact of psoriatic arthritis (PsA) and the growing number of therapeutic options, there has been an intensifying focus on treatment strategy in recent years. In 2015, the Tight Control of Psoriatic Arthritis study confirmed the clinical benefit of using a treat-to-target approach in PsA. This randomised controlled trial found benefits in both arthritis and psoriasis disease activity as well as lower disease impact reported by patients, although participants allocated to tight control experienced a higher rate of serious adverse events. European and international recommendations support the use of a treat-to-target approach in PsA and have offered specific advice on how to do this using outcomes such as the minimal disease activity criteria. However, implementation of this approach in routine practice is low, with real-world data highlighting undertreatment as a result. Recent qualitative work with physicians in the UK has helped researchers to understand the barriers to implementation of treat-to-target in PsA. We now need to address these barriers, provide education and support to non-specialist clinicians in routine practice, and aid the translation of optimal care to the clinic