Posture flexibility and grip strength in horse riders

Since the ability to train the horse to be ambidextrous is considered highly desirable, rider asymmetry is recognized as a negative trait. Acquired postural and functional asymmetry can originate from numerous anatomical regions, so it is difficult to suggest if any is developed due to riding. The aim of this study was therefore to assess symmetry of posture, strength and flexibility in a large population of riders and to determine whether typical traits exist due to riding. 127 right handed riders from the UK and USA were categorized according to years riding (in 20 year increments) and their competition level (using affiliated test levels). Leg length, grip strength and spinal posture were measured and recorded by a physiotherapist. Standing and sitting posture and trunk flexibility were measured with 3-D motion capture technology. Right-left differences were explored in relation to years riding and rider competitive experience. Significant anatomical asymmetry was found for the difference in standing acromion process height for a competition level (-0.07±1.50 cm Intro/Prelim; 0.02±1.31 cm Novice; 0.43±1.27 cm Elementary+; p=0.048) and for sitting iliac crest height for years riding (-0.23±1.36 cm Intro/Prelim; 0.01±1.50 cm Novice; 0.86±0.41 cm Elementary+;p=0.021). For functional asymmetry, a significant interaction was found for lateral bending ROM for years riding x competition level (p=0.047). The demands on dressage riders competing at higher levels may predispose these riders to a higher risk of developing asymmetry and potentially chronic back pain rather than improving their symmetry

Johdon konsultointipalveluiden ostopäätösprosessi julkisen sektorin organisaatioissa

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.Tämän työn tavoitteena on tuottaa kattava kuvaus johdon konsultointipalveluista ja niiden ostamiseen vaikuttavista tekijöistä Suomen julkisen sektorin organisaatioissa. Tutkielman kohteena on johdon konsultointipalveluiden ostopäätösprosessi. Tutkittavana ilmiönä on siis organisaation päätöksenteon prosessi ja siihen vaikuttavat tekijät ostotapahtumassa. Julkisen sektorin ostopäätösprosessia johdon konsultointia hankittaessa tarkastellaan tässä työssä historiallisessa ja teoreettisessa kontekstissa, sekä empiirisen tutkimuksen avulla. Lähdeaineistona käytettiin konsultointiin ja organisaation ostokäyttäytymiseen liittyvää kirjallisuutta, sekä empiirisellä kyselyllä kerättyä aineistoa. Kirjallisuuslähteistä ensisijaisimpana käytettiin Paula Kyrön PKT-säätiölle tekemiä laajoja selvityksiä johdon konsultoinnista toimialana vuosilta 1996 ja 1999. Tutkielman pääasiallisena lähteenä käytettiin tutkielman empiirisessä osuudessa kerättyä tutkimustietoa. Empiirinen kysely toteutettiin internetissä syksyllä 1999. Kysely kohdistettiin kahdelle eri ryhmälle: julkisen sektorin hallintojohtajille, sekä joukolle johdon konsultointipalveluiden asiantuntijoita joiden vastauksia käytettiin vertailuaineistona. Internet-kyselyllä kerätty aineisto analysoitiin kuvailevan tilastotieteen keinoin. Tutkimuksessa havaittiin, että johdon konsultointipalveluiden käyttö on varsin yleistä julkisen sektorin organisaatioiden keskuudessa: noin 75% julkisen sektorin organisaatioista käyttää tänä päivänä johdon konsultointipalveluja ja käyttö on tulevaisuudessa lisääntymässä. Konsultointipalveluja ostetaan tyypillisimmin johdon ja henkilöstön koulutukseen, organisaatiomuutoksiin sekä strategiseen suunnitteluun. Tutkimuksen perusteella voidaan osoittaa, että johdon konsultointipalvelujen ostaminen on organisaatiolle vaativa ja riskialtis tehtävä, sillä alalla ei ole markkinasuojaa, vaan käytännössä kuka tahansa voi tarjota johdon konsultointipalveluja. Asiakkaan tehtäväksi jää löytää usein laajastakin joukosta palvelun tarjoajia tilanteeseen sopiva asiantuntija. Julkisen sektorin organisaatiot osoittautuivat hyvin asiantunteviksi konsultointi palveluiden ostajiksi. Julkisen sektorin organisaatiot arvostavat johdon konsultointiyrityksissä etenkin yrityksen erityisasiantuntemusta ja hyvää mainetta sekä omia aiempia kokemuksiaan palvelun toimittajasta. Tämän tyyppisten kriteerien painottaminen on alan tutkijoiden mukaan rationaalisinta, sillä johdon konsultointipalveluiden kaltaista aineetonta palvelua ei voida arvioida ennen ostopäätöksentekoa. Tutkimuksen johtopäätöksenä voidaan todeta, että julkinen sektori on tänä päivänä aktiivinen ja varsin vaativa johdon konsultointipalveluiden käyttäjä

Sustainable and Responsible Design Education: Tensions in Transitions

Sustainable and Responsible Design (SRD) harnesses design’s potential to address eco-social problems and in doing so challenge the status quo of design education by reframing the social and ecological consequences, boundaries and agencies of design. This critical and transdisciplinary approach frays the edges of traditional design disciplines with embedded and reflexive modes of learning. We describe characteristics of SRD education and present theories of learning to empower students in this complex terrain. The learning associated with SRD education is ecologically engaged, participative, critical, expansive and designerly. We recount case studies of our own experiences advancing sustainable and responsible undergraduate design education in the UK. We identify path constraints such as disciplinary fragility, appropriation, and power dynamics in the design school. The push for a revision of priorities generates tensions where there is often greenwashing rhetoric of sustainability and inclusivity. We describe strategies and tactics to address these tensions. We highlight the agency we have as educators and designers and argue that design education can only meaningfully participate in response to the challenges presented by climate change, other types of ecocide, and social problems when educators make substantive commitments to supporting sustainability literacies and design approaches that serve the interests of diverse stakeholders

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Background: This paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or "normal birth". The work formed part of COST Actions IS0907: "Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care" (2011-2014) and IS1405: Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care. Methods: A structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in english in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions. Results: A total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or "good" or positive outcomes more generally. Conclusions: The tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures.COST Action IS0907, ‘Childbirth Cultures, Concerns and Consequences: Creating a dynamic EU framework for optimal maternity care’COST Action IS1405, ‘Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH

Dynamic clonal progression in xenografts of acute lymphoblastic leukemia with intrachromosomal amplification of chromosome 21

Intrachromosomal amplification of chromosome 21 is a heterogeneous chromosomal rearrangement occurring in 2% of childhood precursor B-cell acute lymphoblastic leukemia. There are no cell lines with iAMP21 and these abnormalities are too complex to faithfully engineer in animal models. As a resource for future functional and pre-clinical studies, we have created xenografts from intrachromosomal amplification of chromosome 21 leukemia patient blasts and characterised them by in-vivo and ex-vivo luminescent imaging, FLOW immunophenotyping, and histological and ultrastructural analysis of bone marrow and the central nervous system. Investigation of up to three generations of xenografts revealed phenotypic evolution, branching genomic architecture and, compared with other B-cell acute lymphoblastic leukemia genetic subtypes, greater clonal diversity of leukemia initiating cells. In support of intrachromosomal amplification of chromosome 21 as a primary genetic abnormality, it was always retained through generations of xenografts, although we also observed the first example of structural evolution of this rearrangement. Clonal segregation in xenografts revealed convergent evolution of different secondary genomic abnormalities implicating several known tumour suppressor genes and a region, containing the B-cell adaptor, PIK3AP1, and nuclear receptor co-repressor, LCOR, in the progression of B-ALL. Tracking of mutations in patients and derived xenografts provided evidence for co-operation between abnormalities activating the RAS pathway in B-ALL and for their aggressive clonal expansion in the xeno-environment. Bi-allelic loss of the CDKN2A/B locus was recurrently maintained or emergent in xenografts and also strongly selected as RNA sequencing demonstrated a complete absence of reads for genes associated with the deletions

Paternal diet programs offspring health through sperm- and seminal plasma-specific pathways in mice

Parental health and diet at the time of conception determine the development and life-long disease risk of their offspring. While the association between poor maternal diet and offspring health is well established, the underlying mechanisms linking paternal diet with offspring health are poorly defined. Possible programming pathways include changes in testicular and sperm epigenetic regulation and status, seminal plasma composition, and maternal reproductive tract responses regulating early embryo development. In this study, we demonstrate that paternal low-protein diet induces sperm-DNA hypomethylation in conjunction with blunted female reproductive tract embryotrophic, immunological, and vascular remodeling responses. Furthermore, we identify sperm- and seminal plasma-specific programming effects of paternal diet with elevated offspring adiposity, metabolic dysfunction, and altered gut microbiota

Gammaretrovirus-mediated correction of SCID-X1 is associated with skewed vector integration site distribution in vivo

We treated 10 children with X-linked SCID (SCID-X1) using gammaretrovirus-mediated gene transfer. Those with sufficient follow-up were found to have recovered substantial immunity in the absence of any serious adverse events up to 5 years after treatment. To determine the influence of vector integration on lymphoid reconstitution, we compared retroviral integration sites (RISs) from peripheral blood CD3(+) T lymphocytes of 5 patients taken between 9 and 30 months after transplantation with transduced CD34(+) progenitor cells derived from 1 further patient and I healthy donor. Integration occurred preferentially in gene regions on either side of transcription start sites, was clustered, and correlated with the expression level in CD34(+) progenitors during transduction. In contrast to those in CD34(+) cells, RISs recovered from engrafted CD3(+)T cells were significantly overrepresented within or near genes encoding proteins with kinase or transferase activity or involved in phosphorus metabolism. Although gross patterns of gene expression were unchanged in transduced cells, the divergence of RIS target frequency between transduced progenitor cells and post-thymic T lymphocytes indicates that vector integration influences cell survival, engraftment, or proliferation

Subthalamic stimulation affects homophone meaning generation in Parkinson's disease

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in individuals with Parkinson's disease (PD) has often been associated with reduced verbal fluency performance. This study aimed to directly assess semantic switching as a function of STN stimulation in PD participants with the Homophone Meaning Generation Test (HMGT). Seventeen participants with PD who had received STN DBS completed the HMGT in on and off stimulation conditions. Twenty-one non-neurologically impaired participants acted as controls. PD participants (in both on and off stimulation conditions) generated significantly fewer meanings than control participants and consistent with the previous reports of verbal fluency impairment, PD participants produced fewer definitions in the on stimulation condition. PD participants (in both on and off stimulation conditions) also had greater difficulty generating definitions for nonhomographic homophones compared with homographic homographs. The results of this study indicate that STN stimulation exacerbates impairment in semantic switching

Heritage Quay: What Will You Discover? Transforming the Archives of the University of Huddersfield, Yorkshire, UK

The Heritage Quay project is changing how archive services at the University of Huddersfield are delivered. This article examines how the Staff/Space/Collections dependency model and Customer Service Excellence framework have been used, and what lessons can be drawn for other archives

Adjunctive Medication Management and Contingency Management to enhance adherence to acamprosate for alcohol dependence: the ADAM trial RCT

BackgroundAcamprosate is an effective and cost-effective medication for alcohol relapse prevention but poor adherence can limit its full benefit. Effective interventions to support adherence to acamprosate are therefore needed.ObjectivesTo determine the effectiveness of Medication Management, with and without Contingency Management, compared to Standard Support alone in enhancing adherence to acamprosate and the impact of adherence to acamprosate on abstinence and reduced alcohol consumption.DesignMulticentre, three-arm, parallel-group, randomised controlled clinical trial.SettingSpecialist alcohol treatment services in five regions of England (South East London, Central and North West London, Wessex, Yorkshire and Humber and West Midlands).ParticipantsAdults (aged 18 years or more), an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, diagnosis of alcohol dependence, abstinent from alcohol at baseline assessment, in receipt of a prescription for acamprosate.Interventions(1) Standard Support, (2) Standard Support with adjunctive Medication Management provided by pharmacists via a clinical contact centre (12 sessions over 6 months), (3) Standard Support with adjunctive Medication Management plus Contingency Management that consisted of vouchers (up to £120) to reinforce participation in Medication Management. Consenting participants were randomised in a 2 : 1 : 1 ratio to one of the three groups using a stratified random permuted block method using a remote system. Participants and researchers were not blind to treatment allocation.Main outcome measuresPrimary outcome: self-reported percentage of medication taken in the previous 28 days at 6 months post randomisation. Economic outcome: EuroQol-5 Dimensions, a five-level version, used to calculate quality-adjusted life-years, with costs estimated using the Adult Service Use Schedule.ResultsOf the 1459 potential participants approached, 1019 (70%) were assessed and 739 (73 consented to participate in the study, 372 (50%) were allocated to Standard Support, 182 (25%) to Standard Support with Medication Management and 185 (25%) to Standard Support and Medication Management with Contingency Management. Data were available for 518 (70%) of participants at 6-month follow-up, 255 (68.5%) allocated to Standard Support, 122 (67.0%) to Standard Support and Medication Management and 141 (76.2%) to Standard Support and Medication Management with Contingency Management. The mean difference of per cent adherence to acamprosate was higher for those who received Standard Support and Medication Management with Contingency Management (10.6%, 95% confidence interval 19.6% to 1.6%) compared to Standard Support alone, at the primary end point (6-month follow-up). There was no significant difference in per cent days adherent when comparing Standard Support and Medication Management with Standard Support alone 3.1% (95% confidence interval 12.8% to −6.5%) or comparing Standard Support and Medication Management with Standard Support and Medication Management with Contingency Management 7.9% (95% confidence interval 18.7% to −2.8%). The primary economic analysis at 6 months found that Standard Support and Medication Management with Contingency Management was cost-effective compared to Standard Support alone, achieving small gains in quality-adjusted life-years at a lower cost per participant. Cost-effectiveness was not observed for adjunctive Medication Management compared to Standard Support alone. There were no serious adverse events related to the trial interventions reported.LimitationsThe trial’s primary outcome measure changed substantially due to data collection difficulties and therefore relied on a measure of self-reported adherence. A lower than anticipated follow-up rate at 12 months may have lowered the statistical power to detect differences in the secondary analyses, although the primary analysis was not impacted.ConclusionsMedication Management enhanced with Contingency Management is beneficial to patients for supporting them to take acamprosate