A Physical Therapy Perspective on Rotator Cuff Disease

Rotator Cuff disease is one of the most common shoulder problems seen in the medical setting today. It spans all ages ranging from the young athlete who suffers from overuse syndrome to the older individual who experiences decreased function due to degenerative changes within the shoulder joint. The chief causes of rotator cuff tears are traumatic il1iury and degenerative changes. Tears resulting from trauma usually occur from a lateral blow to the shoulder. Degenerative changes in the rotator cuff result from many factors. These factors include: decreased vascularity, age, shape of the acromion, repetitive trauma, scapular instability, and muscular weakness. The shoulder is a complex joint and proper treatment relies on the physical therapist\u27s knowledge of the anatomy and function of all of the structures involved in the shoulder complex. The therapist must also know how the structures work together to promote the smooth, coordinated movements necessary for normal arm motion. This paper focuses on the causes of rotator cuff pathology with a presentation of the signs and symptoms of rotator cuff disease. Other problems of the shoulder will also be discussed and differential diagnosis of these problems will be presented followed by a discussion of shoulder rehabilitation programs for conservative and surgical treatment of rotator cuff tears

Collaborating With Parents of Children With Chronic Conditions and Professionals to Design, Develop and Pre-pilot PLAnT (the Parent Learning Needs and Preferences Assessment Tool)

© 2017 Elsevier Inc. Purpose This study aimed to design, develop and pre-pilot an assessment tool (PLAnT) to identify parents' learning needs and preferences when carrying out home-based clinical care for their child with a chronic condition. Design and Methods A mixed methods, two-phased design was used. Phase 1: a total of 10 parents/carers and 13 professionals from six UK's children's kidney units participated in qualitative interviews. Interview data were used to develop the PLAnT. Eight of these participants subsequently took part in an online survey to refine the PLAnT. Phase 2: thirteen parents were paired with one of nine professionals to undertake a pre-pilot evaluation of PLAnT. Data were analyzed using the Framework approach. Results A key emergent theme identifying parents' learning needs and preferences was identified. The importance of professionals being aware of parents' learning needs and preferences was recognised. Participants discussed how parents' learning needs and preferences should be identified, including: the purpose for doing this, the process for doing this, and what would the outcome be of identifying parents' needs. Conclusions The evidence suggests that asking parents directly about their learning needs and preferences may be the most reliable way for professionals to ascertain how to support individual parents' learning when sharing management of their child's chronic condition. Practice Implications With the increasing emphasis on parent-professional shared management of childhood chronic conditions, professionals can be guided by PLAnT in their assessment of parents' learning needs and preferences, based on identified barriers and facilitators to parental learning

The gastric acid pocket is attenuated in H. pylori infected subjects

Objective Gastric acid secretory capacity in different anatomical regions, including the postprandial acid pocket, was assessed in Helicobacter pylori positive and negative volunteers in a Western population. Design We studied 31 H. pylori positive and 28 H. pylori negative volunteers, matched for age, gender and body mass index. Jumbo biopsies were taken at 11 predetermined locations from the gastro-oesophageal junction and stomach. Combined high-resolution pH metry (12 sensors) and manometry (36 sensors) was performed for 20 min fasted and 90 min postprandially. The squamocolumnar junction was marked with radio-opaque clips and visualised radiologically. Biopsies were scored for inflammation and density of parietal, chief and G cells immunohistochemically. Results Under fasting conditions, the H. pylori positives had less intragastric acidity compared with negatives at all sensors >1.1 cm distal to the peak lower oesophageal sphincter (LES) pressure (p<0.01). Postprandially, intragastric acidity was less in H. pylori positives at sensors 2.2, 3.3 and 4.4 cm distal to the peak LES pressure (p<0.05), but there were no significant differences in more distal sensors. The postprandial acid pocket was thus attenuated in H. pylori positives. The H. pylori positives had a lower density of parietal and chief cells compared with H. pylori negatives in 10 of the 11 gastric locations (p<0.05). 17/31 of the H. pylori positives were CagA-seropositive and showed a more marked reduction in intragastric acidity and increased mucosal inflammation. Conclusions In population volunteers, H. pylori positives have reduced intragastric acidity which most markedly affects the postprandial acid pocket

Poverty and Disability: A critical review of the literature in low and middle-income countries

While it is widely assumed that disability, poverty and health are closely linked, this is the first critical review on the subject that explicitly asks: ‘What is the current evidence base for the link between poverty, disability and health in low- and middle-income countries? The methods used have been adapted from the EPPI Centre (EPPI-Centre, 2007) and the work of Greenhalgh (Greenhalgh, Robert, Macfarlane, Bate, Kyriakidou, & Peacock, 2005) A total of 964 papers were identified and, of these, 293 were selected for further review based on appropriateness of fit. An initial review of the 293 papers, paying particular attention to those papers that presented an evidence base, found only 27 papers (9.2% of total papers reviewed) met the established inclusion criteria for a critical review. Widening these inclusion criteria did not produce significantly more evidence based papers for review. Thus, the most significant finding from this study is the current lack of strong evidence on the links between disability, poverty and health in LMICs upon which to build global policy and programming. Within the group of papers available for review, we identify a small but growing evidence base that indicates that there are substantial links between disability, poverty and health; however emerging research indicates that these links are more complex and nuanced than is currently assumed. We conclude with a call for more attention to building an evidence base on the interactions between disability, poverty and health. The absence of a robust evidence base that explicitly links these issues, in conjunction with the lack of appropriate benchmarks and indicators to measure disability rights commitments (including poverty reduction), will otherwise result in a “democratic deficit”

Эвакуация населения при чрезвычайных ситуациях

В результате аварии на Чернобыльской АЭС (1986 г.) радиационное загрязнение затронуло все страны Северного полушария. На опасно загрязненных территориях оказалось более 1 млн. чел. В ряду поколений число смертельных онкологических заболеваний может составить десятки тысяч человек.As a result of the Chernobyl accident (1986), all countries of the Northern Hemisphere were affected by radiation pollution. In dangerously contaminated areas was more than 1 million people. In a number of generations, the number of deadly cancer can amount to tens of thousands of people

Daylight: What Makes a Difference

Light is necessary for vision; it enables us to sense and perceive our surroundings and in many direct and indirect ways, via eye and skin, affects our physiological and psychological health. The use of light in built environments has comfort, behavioural, economic and environmental consequences. Daylight has many particular benefits including excellent visual performance, permitting good eyesight, effective entrainment of the circadian system as well as a number of acute non-image forming effects and the important role of vitamin D production. Some human responses to daylight seem to be well defined whilst others require more research to be adequately understood. This paper presents an overview of current knowledge on how the characteristics of daylight play a role in fulfilling these and other functions often better than electric lighting as conventionally delivered

Micro- and nanosystems for biology and medicine

The development of new tools and instruments for biomedical applications based on nano- (NEMS) or microelectromechanical systems technology (MEMS) are bridging the gap between the macro- and the nano-world. The well mastered microtechnique allows controlling many parameters of these instruments, which is essential for conducting reproducible and repeatable experiments in the life sciences. Examples are multifunctional scanning probe sensors for cell biology, an arthroscopic scanning force microscope for minimally invasive medical interventions and a nanopore sensor for single molecule experiments in biochemistry. This paper reviews some of the activities conducted in a fruitful interdisciplinary collaboration between physicists, engineers, biologists and physicians

Quality of sleep in patients with schizophrenia is associated with quality of life and coping

BACKGROUND: While sleep disturbance is widespread in schizophrenia it is less clear whether sleep disturbance is uniquely related to impaired coping and perceived quality of life. METHODS: We simultaneously assessed sleep quality, symptoms, and coping in 29 persons with schizophrenia or schizoaffective disorder in a post acute phase of illness. Assessment instruments included the Pittsburgh Sleep Quality Index; the Positive and Negative Symptom Scale; the Heinrichs Quality of Life Scale; and the Ways of Coping Scale. Multiple regressions were performed predicting quality of life and coping from sleep quality controlling for age and symptom severity. On a subset of seven subjects non-dominant wrist actigraphy was used as an objective check of their self-reported poor sleep. RESULTS: Analyses revealed that poor sleep quality predicted low quality of life (r = -0.493; p = .022) and reduced preference for employing positive reappraisal when facing a stressor (r = -0.0594; p = 0.0012). Actigraphy confirmed poor sleep quality in a subset of subjects. They had shorter sleep duration (p < .0005), shorter average sleep episodes (p < .005) and more episodes of long awakening (p < 0.05) than community norms. CONCLUSION: The results are consistent with the hypotheses that poor sleep may play a unique role in sustaining poor quality of life and impaired coping in patients with schizophrenia. These associations may hold for community controls as well

Human rhinoviruses enter and induce proliferation of B lymphocytes

Background: Human rhinoviruses (HRVs) are one of the main causes of virus-induced asthma exacerbations. Infiltration of B lymphocytes into the subepithelial tissue of the lungs has been demonstrated during rhinovirus infection in allergic individuals. However, the mechanisms through which HRVs modulate the immune responses of monocytes and lymphocytes are not yet well described. Objective: To study the dynamics of virus uptake by monocytes and lymphocytes, and the ability of HRVs to induce the activation of in vitro-cultured human peripheral blood mononuclear cells. Methods: Flow cytometry was used for the enumeration and characterization of lymphocytes. Proliferation was estimated using 3H-thymidine or CFSE labeling and ICAM-1 blocking. We used bead-based multiplex assays and quantitative PCR for cytokine quantification. HRV accumulation and replication inside the B lymphocytes was detected by a combination of in situ hybridization (ISH), immunofluorescence, and PCR for positive-strand and negative-strand viral RNA. Cell images were acquired with imaging flow cytometry. Results: By means of imaging flow cytometry, we demonstrate a strong and quick binding of HRV types 16 and 1B to monocytes, and slower interaction of these HRVs with CD4+ T cells, CD8+ T cells, and CD19+ B cells. Importantly, we show that HRVs induce the proliferation of B cells, while the addition of anti-ICAM-1 antibody partially reduces this proliferation for HRV16. We prove with ISH that HRVs can enter B cells, form their viral replication centers, and the newly formed virions are able to infect HeLa cells. In addition, we demonstrate that similar to epithelial cells, HRVs induce the production of pro-inflammatory cytokines in PBMCs. Conclusion: Our results demonstrate for the first time that HRVs enter and form viral replication centers in B lymphocytes and induce the proliferation of B cells. Newly formed virions have the capacity to infect other cells (HeLa). These findings indicate that the regulation of human rhinovirus-induced B-cell responses could be a novel approach to develop therapeutics to treat the virus-induced exacerbation of asthma.</p

Magnetically Shielded Miniature Hall Thruster: Design Improvement and Performance Analysis

ABSTRACT: Magnetic shielding has been shown to dramatically reduce discharge channel wall erosion of high powered Hall thrusters, thereby increasing their useful lifetimes. However, unique challenges exist for developing a low power magnetically shielded Hall thruster. A previously tested 4 cm magnetically shielded miniature Hall thruster demonstrated low performance of its magnetic circuit, resulting in an asymmetric field topology, low thrust, and low efficiency. A 6 cm magnetically shielded Hall thruster was developed to improve upon the 4 cm design. The 6 cm device, which generated a symmetric and fully shielded field topology, was tested at 30 operating conditions ranging from 160 W to nearly 750 W. Visual observation of the plasma and discharge channel during and after operation was used to assess the level of magnetic shielding that was achieved. Hall2De plasma simulations were also used to offer further evidence of magnetic shielding. Thrust stand measurements provided thrust, anode specific impulse, and anode efficiency data at each operating condition. Pole face erosion, which is believed to be associated with the 6 cm thruster&apos;s non-optimized magnetic shielding field topology and strength, identify the near-term challenges to resolve before long lifetimes and high efficiencies can be achieved in low power Hall thrusters