THE EFFECTS OF ORTHOTICS AND INCREASED PLANTAR SOLE MECHANORECEPTOR ACTIVATION ON TURNING PERFORMANCE IN INDIVIDUALS WITH PARKINSON’S DISEASE

Locomotion and turning are complex movement patterns essential to activities of daily living. Individuals with Parkinson’s disease (PD) report difficulties turning, often coupled with impaired balance and increased fear of falling. The purpose of this within-subject study was to determine if orthotics, with and without a textured top cover, can improve gait stability and turning performance within Parkinson’s participants. Seven participants with a diagnosis of idiopathic Parkinson’s disease, aged 55-80 years old, participated in the study. Participants completed three testing sessions; baseline, 4 weeks post-baseline, and 5 weeks post-baseline. The ‘footwear only’ and ‘footwear + non-textured orthotic’ conditions were tested at baseline, ‘footwear + non-textured orthotic’ and ‘footwear + textured orthotic’ conditions were testing at 4-weeks, and the ‘footwear + textured orthotic’ condition was repeated at 5 weeks. Kinematic, kinetic, electromyographical, and video data was collected during a turning task. The turn task consisted of walking towards a pre-determined turn area, and then completing a 180° to static stance. Variables of interest were categorized into three main areas: dynamic stability (COM/BOS ML maximum, minimum, and range), turning performance (turn strategy, step count, step length, step width, and average walking velocity), and average muscle activity of lower limb musculature (tibialis anterior, medial gastrocnemius, and peroneus longus). Results were further subdivided between acute and long-term changes associated with both non-textured and textured orthotics. Long-term orthotic wear and the addition of texture appears to significantly improve dynamic stability, characterized by an increase in the ML maximum and ML range COM/BOS relationship. Significant increases in averaged muscle activity of the ipsilateral tibialis anterior and medial gastrocnemius were noted in the textured orthotic condition, along with significant decreases in ipsilateral peroneus longus. These study results provide two potential treatment options, foot orthotics and textured orthotics, for rehabilitation professionals treating Parkinson’s disease individuals

Remote Sensing of Chiral Signatures on Mars

We describe circular polarization as a remote sensing diagnostic of chiral signatures which may be applied to Mars. The remarkable phenomenon of homochirality provides a unique biosignature which can be amenable to remote sensing through circular polarization spectroscopy. The natural tendency of microbes to congregate in close knit communities would be beneficial for such a survey. Observations of selected areas of the Mars surface could reveal chiral signatures and hence explore the possibility of extant or preserved biological material. We describe a new instrumental technique that may enable observations of this form.Comment: 14 pages, 3 figures; to be published in Planetary and Space Scienc

Within-Compound Versus Public Latrine Access and Child Feces Disposal Practices in Low-Income Neighborhoods of Accra, Ghana.

In crowded urban settlements in low-income countries, many households rely on shared sanitation facilities. Shared facilities are not currently considered "improved sanitation" because of concerns about whether hygiene conditions sufficiently protect users from the feces of others. Prevention of fecal exposure at a latrine is only one aspect of sanitary safety. Ensuring consistent use of latrines for feces disposal, especially child feces, is required to reduce fecal contamination in households and communities. Household crowding and shared latrine access are correlated in these settings, rendering latrine use by neighbors sharing communal living areas as critically important for protecting one's own household. This study in Accra, Ghana, found that household access to a within-compound basic latrine was associated with higher latrine use by children of ages 5-12 years and for disposal of feces of children < 5 years, compared with households using public latrines. However, within-compound access was not associated with improved child feces disposal by other caregivers in the compound. Feces was rarely observed in household compounds but was observed more often in compounds with latrines versus compounds relying on public latrines. Escherichia coli and human adenovirus were detected frequently on household surfaces, but concentrations did not differ when compared by latrine access or usage practices. The differences in latrine use for households sharing within-compound versus public latrines in Accra suggest that disaggregated shared sanitation categories may be useful in monitoring global progress in sanitation coverage. However, compound access did not completely ensure that households were protected from feces and microbial contamination

Socioeconomic inequalities in attitudes to cancer: an international cancer benchmarking study

Socioeconomic status (SES) differences in attitudes towards cancer have been implicated in the differential screening uptake and the timeliness of symptomatic presentation. However, the predominant emphasis of this work has been on cancer fatalism, and many studies focus on specific community subgroups. This study aimed to assess SES differences in positive and negative attitudes towards cancer in UK adults. A population-based sample of UK adults (n=6965, age?50 years) completed the Awareness and Beliefs about Cancer scale, including six belief items: three positively framed (e.g. ‘Cancer can often be cured’) and three negatively framed (e.g. ‘A cancer diagnosis is a death sentence’). SES was indexed by education. Analyses controlled for sex, ethnicity, marital status, age, self-rated health, and cancer experience. There were few education-level differences for the positive statements, and overall agreement was high (all>90%). In contrast, there were strong differences for negative statements (all Ps<0.001). Among respondents with lower education levels, 57% agreed that ‘treatment is worse than cancer’, 27% that cancer is ‘a death sentence’ and 16% ‘would not want to know if I have cancer’. Among those with university education, the respective proportions were 34, 17 and 6%. Differences were not explained by cancer experience or health status. In conclusion, positive statements about cancer outcomes attract near-universal agreement. However, this optimistic perspective coexists alongside widespread fears about survival and treatment, especially among less-educated groups. Health education campaigns targeting socioeconomically disadvantaged groups might benefit from a focus on reducing negative attitudes, which is not necessarily achieved by promoting positive attitudes

Maternal Arterial Stiffness in Women Who Subsequently Develop Pre-Eclampsia

BACKGROUND/OBJECTIVES: Pre-eclampsia (PE) is associated with profound changes in the maternal cardiovascular system. The aim of the present study was to assess whether alterations in the maternal arterial stiffness precede the onset of PE in at risk women. METHODOLOGY/PRINCIPAL FINDINGS: This was a cross sectional study involving 70 pregnant women with normal and 70 women with abnormal uterine artery Doppler examination at 22-24 weeks of gestation. All women had their arterial stiffness (augmentation index and pulse wave velocity of the carotid-femoral and carotid-radial parts of the arterial tree) assessed by applanation tonometry in the second trimester of pregnancy, at the time of the uterine artery Doppler imaging. Among the 140 women participating in the study 29 developed PE (PE group) and 111 did not (non-PE group). Compared to the non-PE group, women that developed PE had higher central systolic (94.9 ± 8.6 mmHg vs 104.3 ± 11.1 mmHg; p  =  < 0.01) and diastolic (64.0 ± 6.0 vs 72.4 ± 9.1; p < 0.01) blood pressures. All the arterial stiffness indices were adjusted for possible confounders and expressed as multiples of the median (MoM) of the non-PE group. The adjusted median augmentation index was similar between the two groups (p  =  0.84). The adjusted median pulse wave velocities were higher in the PE group compared to the non-PE group (carotid-femoral: 1.10 ± 0.14 MoMs vs 0.99 ± 0.11 MoMs; p < 0.01 and carotid-radial: 1.08 ± 0.12 MoMs vs 1.0 ± 0.11 MoMs; p < 0.01). CONCLUSIONS/SIGNIFICANCE: Increased maternal arterial stiffness, as assessed by pulse wave velocity, predates the development of PE in at risk women

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Risk perception among Brazilian individuals with high risk for colorectal cancer and colonoscopy

<p>Abstract</p> <p>Background</p> <p>Risk perception is considered a motivating factor for adopting preventive behaviors. This study aimed to verify the demographic characteristics and cancer family history that are predictors of risk perception and to verify if risk perception is a predictor of colonoscopy adherence.</p> <p>Methods</p> <p>Individuals with a family colorectal cancer history as indicated by a proband with cancer were interviewed by telephone. They responded to a questionnaire covering demographic characteristics, colonoscopy history and four questions on risk perception. Tests of multiple linear regression and logistic regression were used to identify associations between dependent and independent variables.</p> <p>Results</p> <p>The 117 participants belonged to 62 families and had a mean age of 45.2 years. The majority of these individuals were female (74.4%) and from families who met the Amsterdam Criteria (54.7%). The average risk perception was 47.6%, with a median of 50%. The average population perception of individual risk was 55.4%, with a median of 50%. Variables associated with a higher risk perception were age, gender, religion, school level, income, and death of a family member. The variable predicting colonoscopy was receiving medical information regarding risk (odds ratio OR 8.40).</p> <p>Conclusions</p> <p>We found that family cancer history characteristics (number of relatives with cancer, risk classification) are associated with adequate risk perception. Risk perception does not predict colonoscopy in this sample. The only variable that predicted colonoscopy was receiving medical information recommending screening.</p

The WEBT BL Lac Campaign 2000

We present UBVRI light curves of BL Lacertae from May 2000 to January 2001, obtained by 24 telescopes in 11 countries. More than 15000 observations were performed in that period, which was the extension of the Whole Earth Blazar Telescope (WEBT) campaign originally planned for July-August 2000. Rapid flux oscillations are present all the time, involving variations up to a few tenths of mag on hour time scales, and witnessing an intense intraday activity of this source. Colour indexes have been derived by coupling the highest precision B and R data taken by the same instrument within 20 min and after subtracting the host galaxy contribution from the fluxes. The 620 indexes obtained show that the optical spectrum is weakly sensitive to the long-term trend, while it strictly follows the short-term flux behaviour, becoming bluer when the brightness increases. Thus, spectral changes are not related to the host galaxy contribution, but they are an intrinsic feature of fast flares. We suggest that the achromatic mechanism causing the long-term flux base-level modulation can be envisaged in a variation of the relativistic Doppler beaming factor, and that this variation is likely due to a change of the viewing angle. Discrete correlation function (DCF) analysis reveals the existence of a characteristic time scale of variability of about 7 h in the light curve of the core WEBT campaign, while no measurable time delay between variations in the B and R bands is found.Comment: 14 pages, 8 PostScript figures, 5 JPEG figures, in press for A&