Counterfeit drugs and the online pharmaceutical trade, a threat to public safety

Counterfeit pharmaceuticals are a serious and ever-growing threat to public safety. Monitoring the trade is difficult, resulting in the precise scale of the problem being unknown, however evidence shows that it is not just lifestyle drugs that are targeted nowadays. Adverse health problems, including fatalities, have resulted from consumers self-medicating with counterfeit products. Without efforts to enhance the public's knowledge, the problem will continue to persist. The internet is facilitating the trade by providing counterfeiters with a large consumer base and limited risks. The dark net within it allows for anonymous transactions between manufacturer, distributer and consumer. While some online pharmacies are legitimate, there are a growing number of those that are unverified which sell dangerous counterfeit products. Both the packaging and medication are becoming increasingly sophisticated, making it difficult for consumers and law enforcement to identify them without chemical analysis. Counterfeit batches have also been detected in established legal trade routes whereby they are able to, if undetected, end up in high street pharmacies and hospitals. Multiple organisations have set up worldwide operations to dismantle the trade however this is a complex and evolving problem that without significant changes to legislation may never be fully

Evaluation of physical fitness in 11 years old students in Northern Italy: a powerful tool to improve physical education curricula

Purpose: This study was designed to evaluate the physical fitness (PF) in 11 years old students of 7 schools in Brescia. The aim was to provide functional data useful for motor activity promotion by physical education (PE) teaching in middle-lower school. Methods: To assess the four main components of the PF we measured: (1) anthropometric data, i.e. height (m), weight (kg) to calculate BMI (kg/m2); (2) aerobic fitness through the six minutes walking test (6MWT); (3) muscular fitness through the standing broad jump test (SBJT); (4) joint flexibility from the V-Sit and reach test (VSR). Statistical analysis was performed by 2-way ANOVA. Results: 349 children were tested, 257 Italian (I) and 74 Not-Italian (NI); I: 127 males (M) and 130 females (F); NI: 41 M and 33 F. NI children belonged to different ethnic groups. BMI I-M (19.3 +- 3.3) I-F (19.5 +- 3.7) NI-M (20.7 +- 3.6) NI-F (19.9 +- 4.5) 6MWT I-M (720 +- 59) I-F (697 +- 54) NI-M (704 +- 75) NI-F (683 +- 52) SBJT I-M (154 +- 22) I-F (144 +- 21) NI-M (145 +- 24) NI-F (137 +- 21) VSR I-M (- 7 +- 7) I-F (4 +-10) NI-M (- 5 +- 8) NI-F (- 1 +- 10) Statistical differences between groups. BMI I vs NI; M-I vs M-NI; SBJT I vs NI; M(I + NI) vs F(I + NI); M-I vs F-I; VSR M(I + NI) vs F(I + NI); M(I) vs F(I) Conclusions: I group data. BMI mean value of both M and F is close to the 50th percentile according to a previous study concerning North of Italy children. Nonetheless, 15% of M and 11% of F have to be considered overweight [1]. 6MWT and SBJT mean results are even better than those reported for other age-matched European children [2, 3]. VSR data are strongly influenced by gender. M show marked negative results, while F show good flexibility. This difference should be considered in PE curriculum. NI group data. Only two of the PF descriptors are different compared to I data, being BMI and SBJT value higher and lower, respectively, than those of I counterpart. Generally, the resulting overall PF of the investigated students is in line with the literature data. The level of PF can be considered adequate, making this population able to follow PE curriculum aimed to include physical activity in daily life as a tool to discourage its abandon in adulthood. References Cacciari E et al (2002) Eur J Clin Nutr 56:171–180 Ulrich S et al (2013) BMC Pulm Med 13:49–60 Ortega FB et al (2011) Br J Sports Med 45:20–2

Motor unit conduction velocity at different joint angles

Purpose: The aim of this study was to evaluate the dependence of motor unit conduction velocity (MUCV) on the length of the muscle. Methods: Muscle length was modified considering three different ankle angles: 90°,110° and 130°. For each angle the maximal voluntary contraction (MVC) was measured during static ankle dorsiflexion. High-density surface electromyography (HD-sEMG, 128 channels) was recorded from the tibialis anterior muscle (TA) in six young individuals. Subjects executed a volitional effort in which the output tension changed in a trapezoidal ramp fashion (15 s transient and 40 s steady contraction). Two levels of steady contraction were investigated: 10% and 20% of MVC. Using a novel decomposition technique based on HD-sEMG processing (Negro et al. 2016), the individual MUCV values were estimated during the trapezoid steady part. The decomposition was performed at each ankle angle independently, and the MU action potentials were not tracked across different muscle lengths. Results: MVC mean values at 90° and 130° were 91.78% and 78.77% of 110° value respectively. Considering that there was no statistical difference between the MUCV estimations calculated at 10 and 20% MVC, the values were grouped. The average CV was 4.00 ± 0.54 m/ s for 90°, 3.88 ± 0.19 m/s for 110° and 3.77 ± 0.37 m/s for 130°. One-Way Anova analysis showed a weak effect between the three conditions (P = 0.04). Conclusion: MUCV changes were weakly related to the different muscle lengths. Explanation of our results should consider that the muscle fiber can be approximated as a constant volume system and that, from the cable theory, the smaller the diameter the lower the CV is. On these bases, the reduction of muscle fibers transverse diameter during muscle elongation when the ankle angle increases from 90° to 130° could be a possible explanation for our results

Misuse (and abuse?) of the concept of empowerment: the case of online offer of predictive direct-to-consumer genetic tests

oai:ojs.www.jphres.org:article/2Using the field of direct-to-consumer genetic tests as a case in point, this paper argues against the misuse of the term empowerment, and calls for a regulation of its usage. The misleading assumption under certain current usages of the concept of empowerment is that it is enhanced by the provision of health information. While the ‘information-empowerment’ correlation is misleading, if not wrong, the feeling of being empowered imposes an increasing burden of critical thinking on those people (patients and consumers) who have to evaluate that information and act for the benefit of their health