Changes In Jump Performance And Dynamic Balance At High Terrestrial Altitude

The purpose of this study was to examine the effects of altitude on dynamic balance and jump performance of a controlled landing during a 12-day high altitude trek. Following a two-legged jump, time to stabilization (5% of body mass for 0.5 s), maximum power, and jump height were measured in 11 participants using a portable force platform at sea level (BL), 3619 m (C1), and 5140 m (C3). Jump performance significantly decreased at C1 and C3 compared to BL (P=0.001). There were no significant differences found in time to stabilization and maximum power with increasing altitude. The present findings indicate that jump performance is significantly decreased with increasing altitude. However, dynamic balance and jump power remain unaffected

Investigating the laundry logistics system of small-sized public hospital: Can the efficiency of operations be improved under the constraints of Thailand’s administrative culture?

yesPurpose All internal logistics systems contribute to the overall success of healthcare service delivery; laundry management (as a closed loop logistics system) is a critical system which facilitates patient recovery and rehabilitation. Studies indicate that applying efficiency measures/improvement tools in such systems, can deliver financial savings and strengthening of in-house competencies (Banerjea-Brodeur et al. 1998; Golden et al. 2008). This study focuses on the review and improvement of laundry management systems in a Thailand Hospital and the organizational culture underpinning this. This hospital was awarded the highest level of hospital accreditation (high level of quality and environmental compliance within this site). Despite this, problems existed at a very basic level with the laundry management, which can undermine patient dignity and respect and increase risk infection and health complications. This study contributes to the Thai healthcare agenda, a core mission of which is to “Develop efficient and equitable integrated health service system for both normal situation and emergency with emphasis on basic rights, specialized service and emergency medicine, surveillance system, disease prevention and control and health threats” (MOPH 2003). Research Approach The key research methods employed include literature review, in-depth interview, observation, documentation and content analysis. A mixed methods methodology was considered appropriate for this study for a number of reasons including a lack of previous insight into this system and the number of actors involved. To this end a triangulated view of the laundry management system was realized. Findings and Originality Delays in the provision of linen and patient clothing (1-4 days bottleneck) were adversely affected by unstructured laundry operations, insufficient personnel, poor job design and worn-out equipment. As a result of this analysis several solutions were steadily implemented which led to: (i) linen shortage was reduced by 12.12% - 28.48%, and (ii) the total cleaning time per cycle was reduced by 130 minutes (45.12%). The impact of the improvement practices in place were perceived to be undermined by cultural factors such as very high internal conflict, the new hospital Director with relatively low power, and limited budget allocated to purchasing linen. Research Impacts Very few studies have explored a closed-loop supply chain of hospital laundry management systems, fewer collected data from key users using a mixed methods methodology. Reverse Exchanges (RE), a new theoretical framework, was adopted to examine the laundry processes. This study attempts to this study fill these gaps. Although this research studied one district hospital; the practices can be greatly generalized; and the diagram of laundry operations and this research design can be replicated. Practical Impacts Improvement measures have been identified which directly impact on the effectiveness and efficiency of this operation. Whilst this is once case study site analysis, this can offer a positive contribution to the healthcare agenda within this country

Evidence for interplay between genes and parenting on infant temperament in the first year of life: monoamine oxidase A polymorphism moderates effects of maternal sensitivity on infant anger proneness

Background The low expression polymorphism of the MAOA gene in interaction with adverse environments (G × E) is associated with antisocial behaviour disorders. These have their origins in early life, but it is not known whether MAOA G × E occurs in infants. We therefore examined whether MAOA G × E predicts infant anger proneness, a temperamental dimension associated with later antisocial behaviour disorders. In contrast to previous studies, we examined MAOA G × E prospectively using an observational measure of a key aspect of the infant environment, maternal sensitivity, at a specified developmental time point. Methods In a stratified epidemiological cohort recruited during pregnancy, we ascertained MAOA status (low vs. high expression alleles) from the saliva of 193 infants, and examined specific predictions to maternal report of infant temperament at 14 months from maternal sensitivity assessed at 29 weeks of age. Results Analyses, weighted to provide general population estimates, indicated a robust interaction between MAOA status and maternal sensitivity in the prediction of infant anger proneness (p = .003) which became stronger once possible confounders for maternal sensitivity were included in the model (p = .0001). The interaction terms were similar in males (p = .010) and females (p = .016), but the effects were different as a consequence of an additional sex of infant by maternal sensitivity interaction. Conclusions This prospective study provides the first evidence of moderation by the MAOA gene of effects of parenting on infant anger proneness, an important early risk for the development of disruptive and aggressive behaviour disorders

Interdisciplinary Perspectives on Restraint Use in Aged Care.

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected 'Restraint' as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the 'last resort'. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, physicians, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint; 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly 'low-level' forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but specified that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care

Big Data in Maritime Archaeology: Challenges and Prospects from the Middle East and North Africa

The Middle East and North Africa have witnessed a surfeit of geospatial data collection projects, resulting in big databases with powerful deductive capacities. Despite the valuable insights and expansive evidentiary record offered by those databases, emphasis on anthropogenic threats to cultural heritage, combined with a limited integration of local perspectives, have raised important questions on the ethical and epistemological dimensions of big data. This paper contextualizes maritime cultural heritage (MCH) in those debates through the lens of the Maritime Endangered Archaeology in the Middle East and North Africa project (MarEA). MarEA is developing a unique for the region database for MCH designed to amalgamate a baseline record emphasizing spatial location, state of preservation, and vulnerability. This record will form a stepping stone toward finer-grained research on MCH and its interdisciplinary intersections. It is also developed as an information resource to facilitate local collaborators in prioritizing site monitoring and developing documentation, management, and mitigation strategies

Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis

Objective: To determine long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus infections after hospitalization or intensive care unit admission. Data sources: Ovid MEDLINE, EMBASE, CINAHL Plus, and PsycINFO were searched. Study selection: Original studies reporting clinical outcomes of adult SARS and MERS survivors 3 months after admission or 2 months after discharge were included. Data extraction: Studies were graded using the Oxford Centre for Evidence-Based Medicine 2009 Level of Evidence Tool. Meta-analysis was used to derive pooled estimates for prevalence/severity of outcomes up to 6 months after hospital discharge, and beyond 6 months after discharge. Data synthesis: Of 1,169 identified studies, 28 were included in the analysis. Pooled analysis revealed that common complications up to 6 months after discharge were: impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 15–45%); and reduced exercise capacity (mean 6-min walking distance 461 m, CI 450–473 m). The prevalences of post-traumatic stress disorder (39%, 95% CI 31–47%), depression (33%, 95% CI 20–50%) and anxiety (30%, 95% CI 10–61) beyond 6 months after discharge were considerable. Low scores on Short-Form 36 were identified beyond 6 months after discharge. Conclusion: Lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors. Clinicians should anticipate and investigate similar long-term outcomes in COVID-19 survivors

Mental health in UK Biobank - development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis

Background UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential. Aims Describe the development, implementation and results of this questionnaire. Method An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use. Results A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45–82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation. Conclusions The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health

A Genome Assembly-Integrated Dog 1 Mb BAC Microarray: A Cytogenetic Resource for Canine Cancer Studies and Comparative Genomic Analysis

Molecular cytogenetic studies have been instrumental in defining the nature of numerical and structural chromosome changes in human cancers, but their significance remains to be fully understood. The emergence of high quality genome assemblies for several model organisms provides exciting opportunities to develop novel genome-integrated molecular cytogenetic resources that now permit a comparative approach to evaluating the relevance of tumor-associated chromosome aberrations, both within and between species. We have used the dog genome sequence assembly to identify a framework panel of 2,097 bacterial artificial chromosome (BAC) clones, selected at intervals of approximately one megabase. Each clone has been evaluated by multicolor fluorescence in situ hybridization (FISH) to confirm its unique cytogenetic location in concordance with its reported position in the genome assembly, providing new information on the organization of the dog genome. This panel of BAC clones also represents a powerful cytogenetic resource with numerous potential applications. We have used the clone set to develop a genome-wide microarray for comparative genomic hybridization (aCGH) analysis, and demonstrate its application in detection of tumor-associated DNA copy number aberrations (CNAs) including single copy deletions and amplifications, regional aneuploidy and whole chromosome aneuploidy. We also show how individual clones selected from the BAC panel can be used as FISH probes in direct evaluation of tumor karyotypes, to verify and explore CNAs detected using aCGH analysis. This cytogenetically validated, genome integrated BAC clone panel has enormous potential for aiding gene discovery through a comparative approach to molecular oncology.Organismic and Evolutionary Biolog

Gerbes, M5-Brane Anomalies and E_8 Gauge Theory

Abelian gerbes and twisted bundles describe the topology of the NS-NS 3-form gauge field strength H. We review how they have been usefully applied to study and resolve global anomalies in open string theory. Abelian 2-gerbes and twisted nonabelian gerbes describe the topology of the 4-form field strength G of M-theory. We show that twisted nonabelian gerbes are relevant in the study and resolution of global anomalies of multiple coinciding M5-branes. Global anomalies for one M5-brane have been studied by Witten and by Diaconescu, Freed and Moore. The structure and the differential geometry of twisted nonabelian gerbes (i.e. modules for 2-gerbes) is defined and studied. The nonabelian 2-form gauge potential living on multiple coinciding M5-branes arises as curving (curvature) of twisted nonabelian gerbes. The nonabelian group is in general $\tilde\Omega E_8$, the central extension of the E_8 loop group. The twist is in general necessary to cancel global anomalies due to the nontriviality of the 11-dimensional 4-form G field strength and due to the possible torsion present in the cycles the M5-branes wrap. Our description of M5-branes global anomalies leads to the D4-branes one upon compactification of M-theory to Type IIA theory.Comment: 19 page