Interventions to Promote More Effective Balance-Recovery Reactions in Industrial Settings: New Perspectives on Footwear and Handrails

“Change-in-support” balance-recovery reactions that involve rapid stepping or reaching movements play a critical role in preventing falls. Recent geriatrics studies have led to new interventions to improve ability to execute these reactions effectively. Some of these interventions have the potential to reduce fall risk for younger persons working in industrial settings. In this paper, we review research pertaining to two such interventions: 1) balance-enhancing footwear insoles designed to improve stepping reactions, and 2) proximity-triggered handrail cueing systems designed to improve reach-to-grasp reactions. The insole has a raised ridge around the perimeter that is intended to improve balance control by providing increased stimulation of sensory receptors on the footsole in situations where loss of balance may be imminent. The cueing system uses flashing lights and/or verbal prompts to attract attention to the handrail and ensure that the brain registers its location, thereby facilitating more rapid and accurate grasping of the rail if and when sudden loss of balance occurs. Results to date support the efficacy of both interventions in geriatric populations. There is also some evidence that these interventions may improve balance control in younger persons; however, further research is needed to confirm their efficacy in preventing falls in industrial settings

Science-based restoration monitoring of coastal habitats, Volume One: A framework for monitoring plans under the Estuaries and Clean Waters Act of 2000 (Public Law 160-457)

Executive Summary: The Estuary Restoration Act of 2000 (ERA), Title I of the Estuaries and Clean Waters Act of 2000, was created to promote the restoration of habitats along the coast of the United States (including the US protectorates and the Great Lakes). The NOAA National Centers for Coastal Ocean Science was charged with the development of a guidance manual for monitoring plans under this Act. This guidance manual, titled Science-Based Restoration Monitoring of Coastal Habitats, is written in two volumes. It provides technical assistance, outlines necessary steps, and provides useful tools for the development and implementation of sound scientific monitoring of coastal restoration efforts. In addition, this manual offers a means to detect early warnings that the restoration is on track or not, to gauge how well a restoration site is functioning, to coordinate projects and efforts for consistent and successful restoration, and to evaluate the ecological health of specific coastal habitats both before and after project completion (Galatowitsch et al. 1998). The following habitats have been selected for discussion in this manual: water column, rock bottom, coral reefs, oyster reefs, soft bottom, kelp and other macroalgae, rocky shoreline, soft shoreline, submerged aquatic vegetation, marshes, mangrove swamps, deepwater swamps, and riverine forests. The classification of habitats used in this document is generally based on that of Cowardin et al. (1979) in their Classification of Wetlands and Deepwater Habitats of the United States, as called for in the ERA Estuary Habitat Restoration Strategy. This manual is not intended to be a restoration monitoring “cookbook” that provides templates of monitoring plans for specific habitats. The interdependence of a large number of site-specific factors causes habitat types to vary in physical and biological structure within and between regions and geographic locations (Kusler and Kentula 1990). Monitoring approaches used should be tailored to these differences. However, even with the diversity of habitats that may need to be restored and the extreme geographic range across which these habitats occur, there are consistent principles and approaches that form a common basis for effective monitoring. Volume One, titled A Framework for Monitoring Plans under the Estuaries and Clean Waters Act of 2000, begins with definitions and background information. Topics such as restoration, restoration monitoring, estuaries, and the role of socioeconomics in restoration are discussed. In addition, the habitats selected for discussion in this manual are briefly described. (PDF contains 116 pages

Adverse Childhood Life Events and Postpartum Mood Episodes in Bipolar Disorder

Background: The early postpartum has been established as a period of increased vulnerability for psychiatric mood illness. Women with bipolar disorder (BD) in particular are at elevated risk of postnatal depression (PND) and of postpartum psychosis (PP). Though adverse childhood life events (ACLEs) have been implicated in the aetiology of PND, this has rarely been studied in relation to PP. Furthermore, despite being at high risk of relapse following childbirth, little research has assessed the relationship between ACLEs and postnatal mood episodes (PNEs) exclusively in women with BD. Therefore, our aim was to explore associations between ACLEs and occurrence of both PND and PP in a large sample of women with BD. Methods: Participants were 665 parous women with BD who had been recruited into the Bipolar Disorder Research Network study. Diagnoses and lifetime psychopathology were obtained via a semi-structured interview (SCAN). Postnatal psychiatric history and experience of 7 ACLEs were also assessed. Where available, all information obtained at interview was confirmed from psychiatric case notes. Women were classified into three groups according to postnatal psychiatric history: 1) those who had experienced no postnatal mood episode (no PNE, n=224), 2) women with a history of PND (n=223) and 3) women who had experienced PP (n=208). A Pearson’s chi-square test was used to compare the prevalence of each type of ACLE between women in the no PNE group and those with a history of PND or PP. Results: Women with PND were significantly more likely to have experienced emotional, sexual or physical abuse in childhood compared with women who had no history of a PNE (p<0.05). In particular, childhood sexual abuse was reported significantly more in the PND than the no PNE group (P<0.05). In contrast, there were no significant differences in the frequency of reporting of any ACLEs between women who had no PNE and those with PP. Conclusions: Our findings indicate that childhood abuse, sexual abuse in particular, is associated with PND among women with BD. In contrast, we found no evidence for an association between any ACLE and PP, suggesting that biological factors are likely to play a more important role in the aetiology of psychosis in the early postpartum

Effects of manipulating hypothalamic triiodothyronine concentrations on seasonal body weight and torpor cycles in siberian hamsters

Peer reviewedPublisher PD

Molecular Genetic Investigation of Bipolar Disorder: Recruitment and Data Collection

Bipolar disorder is a common psychiatric condition with episodes of extreme mood disturbance ranging from mania to depression. We are currently collecting clinically rich data from a large group of individuals with bipolar disorder as part of our ongoing research into the genetic and environmental causes of bipolar disorder. Participants are being recruited to our study with the help of a number of Clinical Studies Officers throughout the UK. Participants are visited in their own homes by a member of our research team. A semi-structured psychiatric interview, Schedules for Clinical Assessment in Neuropsychiatry, is administered and a blood sample collected at the time of interview. Participants are left with a pack of self-rate questionnaires to complete in their own time, which measure psychological aspects of bipolar disorder. We also ask for participants’ consent to gather further information from their case notes to supplement the information provided at interview. Collecting rich clinical data is essential for molecular genetic studies investigating how genetic and environmental factors interact and influence susceptibility to bipolar disorder. We hope the findings of our research will enable a better understanding of the causes of bipolar disorder and will lead to improved treatments in the future

Investigating risk factors for postpartum psychosis in bipolar disorder

Risk of postpartum psychosis (PP) is high in bipolar disorder (BD), however, factors influencing this risk are poorly understood. In particular, whether adverse childhood experiences (ACEs), anxiety disorders and a range of within-pregnancy factors increase risk of PP in BD is yet to be examined. Of within-pregnancy factors that have been investigated, most have been assessed retrospectively. Prospective studies examining risk of PP in BD are scarce. The main aims of this thesis were to a) examine the relationship between ACEs, anxiety disorders and the lifetime occurrence of PP in BD and b) investigate potential within-pregnancy risk factors for PP in BD using a prospective follow-up design. ACEs, anxiety disorders and lifetime occurrence of PP were assessed via semi-structured interview and self-report questionnaires in 504 parous women with DSM-IV BD-I. Withinpregnancy potential risk factors (including medication, sleep, obstetric and psychosocial factors) were assessed prospectively in 103 pregnant women with DSM-5 BD (n=84 BD-I/SA-BD; n=19 BD-II/BD-NOS) via semi-structured interview in late pregnancy (baseline); perinatal psychopathology was assessed via interview at 12-weeks postpartum. All data were supplemented by clinician questionnaires and/or psychiatric case-notes. Neither history of ACEs (p-values of 0.06-0.95) nor anxiety disorders (of any type; p=0.47, phobias; p=0.23, panic; p=0.53) were significantly associated with the lifetime occurrence of PP. 21% women in the prospective sample experienced PP within 6 weeks of delivery. In unadjusted analyses, an episode of mania/affective psychosis during pregnancy (p=0.001; OR 11.67, 95% CI 2.61-52.21) and loss of at least one complete night of sleep across labour/delivery (p=<0.01; OR 5.35, 95% CI 1.50-19.11) significantly increased risk of PP. After adjusting for known lifetime correlates of PP, mania/affective psychosis in pregnancy remained a significant predictor of PP (p=<0.01; OR 16.49, 95% CI 2.76-98.48). Further adjustment revealed prophylactic mood stabilising medication in the postpartum period had little influence in moderating risk of PP (p=0.61; OR 0.67 95% CI 0.14-3.16). No significant associations were found between withinpregnancy psychosocial or psychological factors and PP. This prospective study demonstrated that risk of PP is high in women with BD, despite use of prophylactic mood stabilising medication. History of ACEs or anxiety disorders did not influence lifetime risk of PP. Mania/affective psychosis with onset during pregnancy significantly increased risk of PP, over and above associations with known lifetime risk factors. Sleep loss associated with labour may act as a final common pathway in the triggering of PP. If replicated, these findings have clinical implications for managing risk of PP in women with BD. The role of neurobiological and medication related factors in the pathophysiology of PP requires further investigation in larger samples

Whole Genome Sequencing for Public Health Surveillance of Shiga Toxin-Producing Escherichia coli Other than Serogroup O157

Shiga toxin-producing Escherichia coli (STEC) are considered to be a significant threat to public health due to the severity of gastrointestinal symptoms associated with human infection. In England STEC O157 is the most commonly detected STEC serogroup, however, the implementation of PCR at local hospital laboartories has resulted in an increase in the detection of STEC other than serogroup O157 (non-O157 STEC). The aim of this study was to evaluate the use of whole genome sequencing (WGS) for routine public health surveillance of non-O157 STEC by comparing this approach to phenotypic serotyping and PCR for subtyping the stx-encoding genes. Of the 102 isolates where phenotypic and genotypic serotyping could be compared, 98 gave fully concordant results. The most common non-O157 STEC serogroups detected were O146 (22) and O26 (18). All but one of the 38 isolates that could not be phenotypically serotyped (designated O unidentifiable or O rough) were serotyped using the WGS data. Of the 73 isolates where a flagella type was available by traditional phenotypic typing, all results matched the H-type derived from the WGS data. Of the 140 sequenced non-O157 isolates, 52 (37.1%) harboured stx1 only, 42 (30.0%) had stx2 only, 46 (32.9%) carried stx1 and stx2. Of these, stx subtyping PCR results were available for 131 isolates and 121 of these had concordant results with the stx subtype derived from the WGS data. Non-specific primer binding during PCR amplification, due to the similarity of the stx2 subtype gene sequences was the most likely cause. The results of this study showed WGS provided a reliable and robust one-step process for characterisation of STEC. Deriving the full serotype from WGS data in real time has enabled us to report a higher level of strain discrimination while stx subtyping provides data on the pathogenic potential of each isolate, enabling us to predict clinical outcome of each case and to monitor the emergence of hyper-virulent strains