Muscle activation patterns in shoulder impingement patients

Introduction: Shoulder impingement is one of the most common presentations of shoulder joint problems 1. It appears to be caused by a reduction in the sub-acromial space as the humerus abducts between 60o -120o – the 'painful arc'. Structures between the humeral head and the acromion are thus pinched causing pain and further pathology 2. Shoulder muscle activity can influence this joint space but it is unclear whether this is a cause or effect in impingement patients. This study aimed to observe muscle activation patterns in normal and impingement shoulder patients and determine if there were any significant differences. Method: 19 adult subjects were asked to perform shoulder abduction in their symptomatic arm and non-symptomatic. 10 of these subjects (age 47.9 ± 11.2) were screened for shoulder impingement, and 9 subjects (age 38.9 ± 14.3) had no history of shoulder pathology. Surface EMG was used to collect data for 6 shoulder muscles (Upper, middle and lower trapezius, serratus anterior, infraspinatus, middle deltoids) which was then filtered and fully rectified. Subjects performed 3 smooth unilateral abduction movements at a cadence of 16 beats of a metronome set at 60bpm, and the mean of their results was recorded. T-tests were used to indicate any statistical significance in the data sets. Significance was set at P<0.05. Results: There was a significant difference in muscle activation with serratus anterior in particular showing a very low level of activation throughout the range when compared to normal shoulder activation patterns (<30%). Middle deltoid recruitment was significantly reduced between 60-90o in the impingement group (30:58%).Trends were noted in other muscles with upper trapezius and infraspinatus activating more rapidly and erratically (63:25%; 60:27% respectively), and lower trapezius with less recruitment (13:30%) in the patient group, although these did not quite reach significance. Conclusion: There appears to be some interesting alterations in muscle recruitment patterns in impingement shoulder patients when compared against their own unaffected shoulders and the control group. In particular changes in scapula control (serratus anterior and trapezius) and lateral rotation (infraspinatus), which have direct influence on the sub-acromial space, should be noted. It is still not clear whether these alterations are causative or reactionary, but this finding gives a clear indication to the importance of addressing muscle reeducation as part of a rehabilitation programme in shoulder impingement patients

Genomes of Gardnerella Strains Reveal an Abundance of Prophages within the Bladder Microbiome

Bacterial surveys of the vaginal and bladder human microbiota have revealed an abundance of many similar bacterial taxa. As the bladder was once thought to be sterile, the complex interactions between microbes within the bladder have yet to be characterized. To initiate this process, we have begun sequencing isolates, including the clinically relevant genus Gardnerella. Herein, we present the genomic sequences of four Gardnerella strains isolated from the bladders of women with symptoms of urgency urinary incontinence; these are the first Gardnerella genomes produced from this niche. Congruent to genomic characterization of Gardnerella isolates from the reproductive tract, isolates from the bladder reveal a large pangenome, as well as evidence of high frequency horizontal gene transfer. Prophage gene sequences were found to be abundant amongst the strains isolated from the bladder, as well as amongst publicly available Gardnerella genomes from the vagina and endometrium, motivating an in depth examination of these sequences. Amongst the 39 Gardnerella strains examined here, there were more than 400 annotated prophage gene sequences that we could cluster into 95 homologous groups; 49 of these groups were unique to a single strain. While many of these prophages exhibited no sequence similarity to any lytic phage genome, estimation of the rate of phage acquisition suggests both vertical and horizontal acquisition. Furthermore, bioinformatic evidence indicates that prophage acquisition is ongoing within both vaginal and bladder Gardnerella populations. The abundance of prophage sequences within the strains examined here suggests that phages could play an important role in the species’ evolutionary history and in its interactions within the complex communities found in the female urinary and reproductive tracts

Development of the iCook 4-H Curriculum for Youth and Adults: Cooking, Eating, and Playing Together for Childhood Obesity Prevention

The objective was to describe the development process of a curriculum (iCook 4-H) targeted to low-income, rural, and/or diverse youths and their adult primary meal preparer to promote cooking, eating, and playing together. Lessons learned highlighted the importance of grounding the curriculum in Social Cognitive Theory and applying the experiential 4-H learning model using a multiphased, community-based participatory approach with cyclical development and evaluation, and key modifications made for dissemination and distribution. Findings across 4 testing phases over 6 years and 5 states demonstrated the time-intensive, cyclical process that required flexibility with fidelity to form a hands-on, interactive curriculum

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

The rhythm and rhyme of teaching mathematics: A qualitative study of Cambodian American educators teaching inner city African American students

This research attempts to discover teaching principles and practices that create more equitable learning environs for African American students as the most at-risk group in United States schools. The Rhythm of teaching Black students refers to pace-setting and the teacher to student and student to student to interactions that take place during math. The Rhyme of teaching mathematics to African American students is a reference to demonstrating dedication toward all students by providing compassionate, equitable, rigorous, learning environments. This study examines the historical and social similarities between Cambodian American teachers and inner-city African-American students. The purpose of this research is to provide insights into the beliefs held by participants, and the pedagogical practices that assist Black students toward proficiency and advanced proficiency in mathematics

Relationships are key: building intercultural capabilities for Indigenous postgraduate coursework students and their teachers [final report of the project Keeping on track: teacher leaders for Indigenous postgraduate coursework students]

Relationships are key is the final report of the project Keeping on track: teacher leaders for Indigenous postgraduate coursework students. The project focused on disciplinary and cross-disciplinary leadership to enhance learning and teaching through leadership capacity-building in discipline structures, communities of practice and cross-disciplinary networks, with an emphasis on strengthening teacher leader capabilities of lecturers involved in the teaching of Indigenous postgraduate coursework students.\ud \ud The overall purpose of Keeping on Track was to clearly delineate and to improve teacher leadership practices across higher education institutions in Australia serving Indigenous postgraduate coursework students, as differentiated from practices in supervision of postgraduate research students. Marshall (2008) states that studies that focus on the 'how' of development of leadership capability in learning and teaching are limited. It is the 'how' of teacher leadership which this project addressed, through the design and development of a Blueprint for Intercultural Capabilities informed by the experiences of Indigenous postgraduate course work students and their teachers.\ud \ud The Keeping on Track project aimed to answer three research questions focused on the Indigenous postgraduate coursework experience by collecting and analysing the teaching an d learning experiences of Indigenous students and their teachers in postgraduate coursework programs. Data were collected through an online survey and the establishment and operation of a University Community of Practice (UCoP) at participating universities, through which focus group discussions and interviews were held. Project end aims were to consider the implications of the data collected, and make recommendations for strengthening teacher leadership capabilities in the teaching and learning of Indigenous postgraduate students through the development of a teacher leadership capabilities framework which would be developed, trialled and evaluated.\ud \ud Four findings became clear towards the end of the project:\ud \ud 1. the value of UCoP in forming an intercultural space in which the process of teaching and learning is the focus;\ud \ud 2. that intercultural capabilities are required by both teachers and students to engage fully with the cultural interface of teaching and learning;\ud \ud 3. that this requires intercultural sensitivity (Bennett, 2004); and,\ud \ud 4. that relationships are key to intercultural exchanges and building intercultural sensitivity.\ud \ud As such, there is no recommendation for a teacher leadership framework, but rather recommendation s for encouraging intercultural development through student/teacher encounters facilitated through the establishment of UCoPs . These are:\ud \ud 1. where UCoPs aren't established, that universities through their Learning and Teaching Centres (or equivalent departments), facilitate the development of one in order to encourage student/teacher encounters; and,\ud \ud 2. that the Blueprint for Intercultural Capabilities forms the basis for the functioning of UCoPs

Eartha M.M. White Virtual Reality Experience

A virtual reality experience built in QuestBuild featuring the Eartha M.M. White Museum. The video below is a 360 version of the Eartha M.M. White VR Experience. This version loses the interactive functionality but still offers all of the information. The Eartha M.M. White VR experience tells the story of Northeast Florida native, Eartha M. M. White, a prominent African American female from Jacksonville who founded the Clara White Mission. The VR narrative biography tells the story of Ms. White\u27s life and all of her accomplishments. It also gives a glimpse into her home and base of operations which is now the Eartha M.M. White Museum located in Jacksonville, FL. The QuestBuild file is also available as s sideload from SideQuest VR at the following address: https://sidequestvr.com/app/23105/eartha-mm-white-vr-experiencehttps://digitalcommons.unf.edu/vlc_media/1000/thumbnail.jp