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Chao CT. Enhancing the 4M framework: the critical role of malnutrition in immobility among hospitalized patients. Can J Cardiol 2024:S0828-282X(24)00345-3. [PMID: 38734206 DOI: 10.1016/j.cjca.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Affiliation(s)
- Chia-Ter Chao
- Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan City, Taiwan.
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2
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Mansouri M, Krishnan G, McDonagh DC, Zallek CM, Hsiao-Wecksler ET. Review of assistive devices for the prevention of pressure ulcers: an engineering perspective. Disabil Rehabil Assist Technol 2024; 19:1511-1530. [PMID: 37101406 DOI: 10.1080/17483107.2023.2204127] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/13/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE Pressure ulcers (PUs) are prevalent among immobile bed or wheelchair-reliant individuals who experience prolonged sedentary positions. Pressure relief and frequent repositioning of body posture help to mitigate complications associated with PUs. Adherence with regular repositioning is difficult to maintain due to nursing labour shortages or constraints of in-home caregivers. Manual repositioning, transferring, and lifting of immobile patients are physically demanding tasks for caregivers. This review aimed to explore and categorize these devices, discuss the significant technical challenges that need addressing, and identify potential design opportunities. MATERIALS AND METHODS In this review, a literature search was conducted using PubMED, Science Direct, Google Scholar and IEEE Xplore databases including studies from 1995 until Feb 2023 with keywords such as pressure ulcer, assistive device, pressure relief, repositioning, transfer, etc. Both commercial and research-level devices were included in the search. RESULTS 142 devices or technologies were identified and classified into four main categories that were further subcategorized. Within each category, the devices were investigated in terms of their mechanical design, actuation methods, control strategies, sensing technologies, and level of autonomy. Limitations of current technologies are design complexity, lack of patient comfort, and a lack of autonomy requiring caregivers frequent intervention. CONCLUSIONS Several devices have been developed to help with prevention and mitigation of PUs. There remain challenges that hinder the widespread accessibility and use of current technologies. Advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems.
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Affiliation(s)
- Mahshid Mansouri
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Girish Krishnan
- Department of Industrial & Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Deana C McDonagh
- School of Art + Design and Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Elizabeth T Hsiao-Wecksler
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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3
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Singam A. Mobilizing Progress: A Comprehensive Review of the Efficacy of Early Mobilization Therapy in the Intensive Care Unit. Cureus 2024; 16:e57595. [PMID: 38707138 PMCID: PMC11069628 DOI: 10.7759/cureus.57595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Early mobilization therapy has emerged as a crucial aspect of intensive care unit (ICU) management, aiming to counteract the detrimental effects of prolonged immobility in critically ill patients. This comprehensive review examines the efficacy of early mobilization therapy in the ICU setting, synthesizing evidence from clinical trials, meta-analyses, and guidelines. Key findings indicate that early mobilization is associated with numerous benefits, including reduced muscle weakness, a shorter duration of mechanical ventilation, decreased ICU and hospital length of stay, and improved functional outcomes. However, safety concerns, staffing limitations, and patient-specific considerations pose significant barriers to widespread adoption. Despite these challenges, early mobilization is important for improving ICU patient outcomes. This review underscores the critical need for continued research and implementation efforts to optimize early mobilization protocols, address remaining challenges, and expand access to this beneficial therapy. By working collaboratively to overcome barriers and prioritize early mobilization, healthcare providers can enhance the quality of care and improve outcomes for critically ill patients in the ICU.
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Affiliation(s)
- Amol Singam
- Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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4
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Lechien JR. Management of Pediatric Bilateral Vocal Fold Paralysis: A State-of-the-Art Review of Etiologies, Diagnosis, and Treatments. Children (Basel) 2024; 11:398. [PMID: 38671615 PMCID: PMC11049505 DOI: 10.3390/children11040398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE This paper reviews the current literature about epidemiology, etiologies, diagnosis, and management of pediatric bilateral vocal fold paralysis (PBVFP). METHODS According to PRISMA statements, a narrative review of the current literature was conducted through the PubMed, Scopus, and Cochrane Library databases about the epidemiology, etiologies, diagnosis, and management of PBVFP. RESULTS PBVCP is the second most common congenital laryngeal anomaly in the pediatric population, accounting for 10% to 20% of pediatric laryngeal conditions. PBVCP is related to idiopathic (42.2%), congenital (19.7%), and neurological (16.9%) conditions. A tracheotomy is required in 60% of cases regarding stridor and dyspnea, which are the most prevalent symptoms. The diagnosis is based on the etiological features, clinical presentation, laryngoscopic findings, and objective examinations. Laryngeal electromyography may be used to support the diagnosis in difficult cases, but its reliability depends on the practitioner's experience. The primary differential diagnosis is posterior glottis stenosis, which needs to be excluded regarding therapeutic and management differences with PBVCP. Transient surgical procedures consist of tracheotomy or laterofixation of the vocal fold. Current permanent procedures include uni- or bilateral partial arytenoidectomy, posterior transverse cordotomy, cricoid splits, and laryngeal selective reinnervation. There is no evidence of the superiority of some procedures over others. CONCLUSIONS PBVCP is the second most common laryngeal disorder in the pediatric population. Diagnosis is based on etiological and clinical findings and may require the use of laryngeal electromyography. Therapeutic management may involve several transient or permanent surgical procedures that are associated with overall subjective improvements in symptoms, laryngeal findings, and low complication rates.
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Affiliation(s)
- Jerome R. Lechien
- Research Committee of the Young Otolaryngologists of the International Federation of Otorhinolaryngological Societies, 92150 Paris, France;
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, B1000 Brussels, Belgium
- Department of Otolaryngology, Elsan Hospital, 92150 Paris, France
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
- Division of Laryngology and Bronchoesophagology, Department of Otolaryngology Head Neck Surgery, Faculty of Medicine, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium
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5
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O'Neill DE, Heckman GA, Graham MM. The epidemic of immobility in hospitalized patients: How to get your patient up and moving. Can J Cardiol 2024:S0828-282X(24)00271-X. [PMID: 38522622 DOI: 10.1016/j.cjca.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024] Open
Abstract
The global population is ageing and with cardiovascular disease (CVD) prevalence also increasing, the face of the prototypical cardiology inpatient is changing, from a middle-aged man with cardiovascular risk factors, to an older adult with multimorbidity and frailty. Hospital care is inherently harmful, with immobilization and reliance on others causing functional decline to be the leading complication of hospitalization in older adults. It is imperative to reinvent hospital care, employing age-friendly health systems to maintain health and function in older adults, improving not only CVD outcomes, but patient-centered outcomes such as function and independence and preventing avoidable harms.
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Affiliation(s)
- Deirdre E O'Neill
- Assistant Professor of Medicine, Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada, T6G 2R7.
| | - George A Heckman
- Schlegel Research Chair in Geriatric Medicine and Associate Professor, School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada, N2G 3G1.
| | - Michelle M Graham
- Professor of Medicine, Division of Cardiology, University of Alberta and Mazankowski Alberta Heart Institute, 8440-112 St, University of Alberta, Edmonton, Alberta, Canada T6G 2B7.
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6
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Ali A. Displacement in Place and the Financial Crisis in Lebanon. J Refug Stud 2024; 37:201-219. [PMID: 38559595 PMCID: PMC10977867 DOI: 10.1093/jrs/fead076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/01/2023] [Indexed: 04/04/2024]
Abstract
Displacement is underway in Lebanon after financial collapse, but not as events of migration, rather, as processual disruption to people's lives that begins in place, preceding the potential outcome of forced migration. Financial collapse has shifted the population into extremes of constraint, dispossessing them of assets needed to live in valued ways. Widely circulated claims of an exodus are premature. Historic mass emigration from Lebanon occurred in times of capital availability whilst today's financial collapse denies most people of the capital needed to emigrate. Migration remains limited to the few with social and cultural capital unaffected by the crisis. This article was prompted by the author's observations of financial collapse whilst living in Lebanon in 2020 and long-standing engagement with the country. Regardless of whether mass emigration occurs, perhaps after the economy's recapitalization, the displacement process already underway warrants attention from refugee and forced migration studies.
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Affiliation(s)
- Ali Ali
- Geography Department, University of Sussex, Brighton BN1 9RH, UK
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7
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Lechien JR, Hans S, Mau T. Management of Bilateral Vocal Fold Paralysis: A Systematic Review. Otolaryngol Head Neck Surg 2024; 170:724-735. [PMID: 38123531 DOI: 10.1002/ohn.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/31/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To review the current literature about epidemiology, etiologies and surgical management of bilateral vocal fold paralysis (BVFP). DATA SOURCES PubMED, Scopus, and Cochrane Library. REVIEW METHODS A systematic review of the literature on epidemiology, etiologies, and management of adult patients with BVFP was conducted through preferred reporting items for systematic reviews and meta-analyses statements by 2 investigators. RESULTS Of the 360 identified papers, 245 were screened, and of these 55 were considered for review. The majority (76.6%) of BVFP cases are iatrogenic. BVFP requires immediate tracheotomy in 36.2% of cases. Laterofixation of the vocal fold was described in 9 studies and is a cost-effective alternative procedure to tracheotomy while awaiting potential recovery. Unilateral and bilateral posterior transverse cordotomy outcomes were reported in 9 and 7 studies, respectively. Both approaches are associated with a 95.1% decannulation rate, adequate airway volume, but voice quality worsening. Unilateral/bilateral partial arytenoidectomy data were described in 4 studies, which reported lower decannulation rate (83%) and better voice quality outcome than cordotomy. Revision rates and complications vary across studies, with complications mainly involving edema, granuloma, fibrosis, and scarring. Selective posterior cricoarytenoid reinnervation is being performed by more surgeons and should be a promising addition to the BVFP surgical armamentarium. CONCLUSION Depending on techniques, the management of BVFP may be associated with several degrees of airway improvements while worsened or unchanged voice quality. The heterogeneity between studies, the lack of large-cohort controlled randomized studies and the confusion with posterior glottic stenosis limit the draw of clear conclusion about the superiority of some techniques over others.
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Affiliation(s)
- Jérôme R Lechien
- Department of Otolaryngology, Elsan Hospital, Paris, France
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Division of Laryngology and Bronchoesophagology, Department of Otolaryngology Head Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, Faculty of Medicine, University of Mons (UMons), Mons, Belgium
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Brussels, Belgium
| | - Stéphane Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Ted Mau
- Department of Otolaryngology-Head and Neck Surgery, Clinical Center for Voice Care, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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8
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Cola RB, Roccaro-Waldmeyer DM, Naim S, Babalian A, Seebeck P, Alvarez-Bolado G, Celio MR. Chemo- and optogenetic activation of hypothalamic Foxb1-expressing neurons and their terminal endings in the rostral-dorsolateral PAG leads to tachypnea, bradycardia, and immobility. eLife 2024; 12:RP86737. [PMID: 38300670 PMCID: PMC10945554 DOI: 10.7554/elife.86737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Foxb1 -expressing neurons occur in the dorsal premammillary nucleus (PMd) and further rostrally in the parvafox nucleus, a longitudinal cluster of neurons in the lateral hypothalamus of rodents. The descending projection of these Foxb1+ neurons end in the dorsolateral part of the periaqueductal gray (dlPAG). The functional role of the Foxb1+ neuronal subpopulation in the PMd and the parvafox nucleus remains elusive. In this study, the activity of the Foxb1+ neurons and of their terminal endings in the dlPAG in mice was selectively altered by employing chemo- and optogenetic tools. Our results show that in whole-body barometric plethysmography, hM3Dq-mediated, global Foxb1+ neuron excitation activates respiration. Time-resolved optogenetic gain-of-function manipulation of the terminal endings of Foxb1+ neurons in the rostral third of the dlPAG leads to abrupt immobility and bradycardia. Chemogenetic activation of Foxb1+ cell bodies and ChR2-mediated excitation of their axonal endings in the dlPAG led to a phenotypical presentation congruent with a 'freezing-like' situation during innate defensive behavior.
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Affiliation(s)
- Reto B Cola
- Anatomy and program in Neuroscience, Faculty of Science and Medicine, University of FribourgFribourgSwitzerland
| | - Diana M Roccaro-Waldmeyer
- Anatomy and program in Neuroscience, Faculty of Science and Medicine, University of FribourgFribourgSwitzerland
| | - Samara Naim
- Anatomy and program in Neuroscience, Faculty of Science and Medicine, University of FribourgFribourgSwitzerland
| | - Alexandre Babalian
- Anatomy and program in Neuroscience, Faculty of Science and Medicine, University of FribourgFribourgSwitzerland
| | - Petra Seebeck
- Zurich integrative Rodent Physiology (ZIRP), University of ZürichZürichSwitzerland
| | | | - Marco R Celio
- Anatomy and program in Neuroscience, Faculty of Science and Medicine, University of FribourgFribourgSwitzerland
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Elmahdi E, Yousif BA, Alotaibi MN, Rashikh MA, Alotaibi N, Alsaab S, Alruways AF, Aladhyani A, Aljuaid MM, Alotaibi EH, Alharthy MR, Alotaibi H, Alqahtani DS. Awareness and Knowledge of Venous Thromboembolism Among Saudi Adults in the Dawadmi Province: A Cross-Sectional Study. Cureus 2024; 16:e52742. [PMID: 38384618 PMCID: PMC10880873 DOI: 10.7759/cureus.52742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Background Venous thromboembolism (VTE) significantly contributes to the global disease burden. The annual incidence of VTE is one to two per 1,000 adults worldwide. We aimed to evaluate the awareness and knowledge of VTE risk factors, manifestations, prevention, and treatment options among the general adult population of Dawadmi, Riyadh, Saudi Arabia. Methodology We conducted a cross-sectional study using the self-designed and validated VTE knowledge questionnaire. A survey was conducted online via Google Documents, composed of 12 questions. Participants included in the study were over 18 years old, regardless of their medical history. However, medical students and healthcare providers were excluded. Results A total of 384 participants (46.4% men and 53.6% women) completed the survey; most respondents were between 18 and 28 years of age. Majority of the participants recognized that immobility, obesity, complicated surgery, road traffic accidents, smoking, and old age are the most common risk factors for VTE. However, more than half of the elderly and lower-educated participants did not identify complicated surgery and consumption of oral contraceptive pills as risk factors for VTE. Awareness of VTE was significantly higher among those with a family history of VTE and a graduate degree (p<0.001). Results showed a deficit of awareness and information about VTE, especially among males, those with low education, and elderly participants. Conclusion This study demonstrates the need for more awareness of VTE among the Saudi adult population. The urge to spread awareness and knowledge about VTE among the public in Dawadmi province is required.
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Affiliation(s)
- Essam Elmahdi
- Internal Medicine, College of Medicine, Shaqra University, Dawadmi, SAU
| | | | | | - Mohammad A Rashikh
- Pharmacology and Therapeutics, College of Medicine, Shaqra University, Dawadmi, SAU
| | - Nemer Alotaibi
- Pediatrics, College of Medicine, Shaqra University, Dawadmi, SAU
| | - Saad Alsaab
- Internal Medicine, College of Medicine, Shaqra University, Dawadmi, SAU
| | | | | | - Mohannad M Aljuaid
- Family and Community Medicine, College of Medicine, Shaqra University, Dawadmi, SAU
| | - Eid H Alotaibi
- Medicine, College of Medicine, Shaqra University, Dawadmi, SAU
| | | | - Hallal Alotaibi
- Internal Medicine, College of Medicine, Shaqra University, Dawadmi, SAU
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10
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Murata H, Tashiro S, Sakamoto H, Ishida R, Kuwabara M, Matsuda K, Shiokawa Y, Hirano T, Momozaki R, Maeda K, Wakabayashi H, Yamada S. Impact of rehabilitation dose on body mass index change in older acute patients with stroke: a retrospective observational study. Front Nutr 2023; 10:1270276. [PMID: 38115884 PMCID: PMC10728649 DOI: 10.3389/fnut.2023.1270276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Background It is established that a low body mass index (BMI) correlates with a diminished home discharge rate and a decline in activities of daily living (ADL) capacity among elderly stroke patients. Nevertheless, there exists a paucity of knowledge regarding strategies to mitigate BMI reduction during the acute phase. This investigation seeks to elucidate the impact of rehabilitation dose, as determined by both physical and occupational therapy, on BMI alterations, positing that a heightened rehabilitation dose could thwart BMI decline. Methods This retrospective, observational study was conducted in the stroke unit of a university hospital. Enrollees comprised individuals aged ≥65 years, hospitalized for stroke, and subsequently relocated to rehabilitation facilities between January 2019 and November 2020. The percentage change in BMI (%ΔBMI) was calculated based on BMI values at admission and discharge. Multivariate multiple regression analysis was employed to ascertain the influence of rehabilitation dose on %ΔBMI. Results A total of 187 patients were included in the analysis, of whom 94% experienced a reduction in BMI during acute hospitalization. Following adjustment for sociodemographic and clinical factors, multivariable analyzes revealed a positive association between rehabilitation dose and %ΔBMI (β = 0.338, p < 0.001). Conclusion The findings of this study suggest that, in the context of acute stroke treatment, an augmented rehabilitation dose is associated with a diminished decrease in BMI.
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Affiliation(s)
- Hiroyasu Murata
- Department of Rehabilitation Medicine, Kyorin University Hospital, Mitaka, Japan
| | - Syoichi Tashiro
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Mitaka, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hayato Sakamoto
- Department of Rehabilitation Medicine, Kyorin University Hospital, Mitaka, Japan
| | - Rika Ishida
- Department of Rehabilitation Medicine, Kyorin University Hospital, Mitaka, Japan
| | - Mayuko Kuwabara
- Department of Rehabilitation Medicine, Kyorin University Hospital, Mitaka, Japan
| | - Kyohei Matsuda
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | | | - Teruyuki Hirano
- Department of Stroke and Cerebrovascular Medicine, Kyorin University, Mitaka, Japan
| | - Ryo Momozaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Shinjuku, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Mitaka, Japan
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11
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Malhotra AK, Lozano CS, Shakil H, Smith CW, Ibrahim GM, Lebel DE, Kulkarni AV, Wilson JR, Witiw CD, Nathens AB. Risk factors associated with in-hospital adverse events: a multicenter observational cohort study of 1853 pediatric patients with traumatic spinal cord injury. J Neurosurg Pediatr 2023; 32:701-709. [PMID: 37877947 DOI: 10.3171/2023.8.peds23354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/30/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE In this study, the authors aimed to quantify the frequency of in-hospital major adverse events (AEs) in a multicenter cohort of pediatric patients with spinal cord injury (SCI) managed at North American trauma centers. They also sought to identify patient and injury factors associated with the occurrence of major and immobility-related AEs. METHODS Data derived from the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) were used to identify a cohort of pediatric patients (age < 19 years) with traumatic SCI. The authors identified individuals with major and immobility-related AEs following injury. They used mixed-effects multivariable logistic regression to identify clinical variables associated with AEs after injury. This analytical approach allowed them to account for similarities in care delivery between patients managed in the same trauma settings during the study period while also adjusting for patient-level confounders. The adjusted impact of AEs on in-hospital mortality and length of stay (LOS) were also assessed through further multivariable regression analysis. Additional subgroup analyses were performed to reduce bias associated with competing risks and explore the age-specific risk factor associations with AEs. RESULTS A total of 1853 pediatric patients who sustained either cervical or thoracic SCI were managed at ACS TQIP trauma centers between 2017 and 2020. The most frequently encountered AE types were pressure ulcer, unplanned intubation, cardiac arrest requiring cardiopulmonary resuscitation, and ventilator-associated pneumonia. The crude rate of major in-hospital and immobility-related AEs significantly differed between subgroups, with higher proportions of AEs in complete injuries compared with incomplete injuries. The adjusted risk for major AE following injury was significantly elevated for cervical complete SCI, patients with severe concomitant abdominal injuries, and for those presenting with depressed Glasgow Coma Scale scores less than 13. These same risk factors were associated with major AEs in children older than 8 years but were not significant for younger children (age ≤ 8 years). Complication occurrence was not associated with difference in risk-adjusted mortality (OR 0.72, 95% CI 0.45-1.14), but did increase LOS by 2.2 days (95% CI 1.4-2.7 days). CONCLUSIONS The authors outlined the prevalence of in-hospital AEs in a large multicenter cohort of North American pediatric SCI patients. Important risk factors predisposing this population to AEs include cervical complete injuries, simultaneous abdominal trauma, and Glasgow Coma Scale scores < 13 at presentation. Postinjury complications impacted health resource utilization by increased LOS but did not affect postinjury mortality. These findings have important implications for pediatric SCI providers and future care quality benchmarking.
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Affiliation(s)
- Armaan K Malhotra
- 1Division of Neurosurgery, St. Michael's Hospital, Toronto
- 2Li Ka Shing Knowledge Institute, Unity Health, Toronto
- 3Institute for Health Policy, Management and Evaluation, University of Toronto
| | - Christopher S Lozano
- 1Division of Neurosurgery, St. Michael's Hospital, Toronto
- 2Li Ka Shing Knowledge Institute, Unity Health, Toronto
| | - Husain Shakil
- 1Division of Neurosurgery, St. Michael's Hospital, Toronto
- 2Li Ka Shing Knowledge Institute, Unity Health, Toronto
- 3Institute for Health Policy, Management and Evaluation, University of Toronto
| | - Christopher W Smith
- 1Division of Neurosurgery, St. Michael's Hospital, Toronto
- 2Li Ka Shing Knowledge Institute, Unity Health, Toronto
| | | | - David E Lebel
- 5Department of Orthopaedic Surgery, Hospital for Sick Children, Toronto; and
| | - Abhaya V Kulkarni
- 3Institute for Health Policy, Management and Evaluation, University of Toronto
- 4Division of Neurosurgery, Hospital for Sick Children, Toronto
| | - Jefferson R Wilson
- 1Division of Neurosurgery, St. Michael's Hospital, Toronto
- 2Li Ka Shing Knowledge Institute, Unity Health, Toronto
- 3Institute for Health Policy, Management and Evaluation, University of Toronto
| | - Christopher D Witiw
- 1Division of Neurosurgery, St. Michael's Hospital, Toronto
- 2Li Ka Shing Knowledge Institute, Unity Health, Toronto
- 3Institute for Health Policy, Management and Evaluation, University of Toronto
| | - Avery B Nathens
- 3Institute for Health Policy, Management and Evaluation, University of Toronto
- 6Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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12
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Greaves-Lord K, Alma M, de Graaff B, Landsman J, van der Weide K, Jagersma G, Beskers T, Wubs M, Mandemaker H, van Daalen E, van der Linde J, Stapert AF, Bekius J, Piening S, Landlust A, van Balkom IDC. Clinical stance on response initiation in autistic adults: co-creating an integrative approach based on theory and lived experiences to act from language, via motor movement to wellbeing. Front Psychol 2023; 14:1229596. [PMID: 37780169 PMCID: PMC10539615 DOI: 10.3389/fpsyg.2023.1229596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/09/2023] [Indexed: 10/03/2023] Open
Abstract
Getting 'stuck', literally and figuratively, is a common experience for autistic people. Literally 'stuck' means exhibiting limited response initiation due to immobility with tense muscles and inability to move. Figuratively 'stuck' means loneliness, passivity or captivity in activities that do not offer long-term satisfaction. To further conceptualize this complex phenomenon of limited response initiation in autistic individuals, we performed qualitative interviews and focus groups with autistic people and their family members, followed by brainstorm sessions and a Delphi study with input from a larger panel of experts from multiple backgrounds. We aimed to co-create the outline of an integrative approach to support autistic people in moving away from this 'stuck state' to more flexible, limber 'supple states' in order to live freer, more meaningful, satisfying and peaceful lives. Over time, in interaction with all participants, our shared insight grew. Based on this, we here stipulate a conceptual framework, in which the described 'stuck state' at the micro-level of the muscles/behavior of one individual, probably is caused by feeling/being 'stuck' or 'cramped' at several overarching (i.e., meso and macro) levels. For instance, stuck in relationships with unhealthy dynamics, stuck at home creating short-term calm, trance-like states (e.g., gaming), stuck at an educational level that might fit the individuals' current social-emotional state rather than their potential cognitive level, stuck in a job that pays the bills but does not feel meaningful, nor contributes to a satisfying life with opportunities for personal development. Stuck in a mental/public health care system where ever ongoing changes in policies hinder sustained support to suit care-needs. Stuck in a regulated societal system making it likely to repeatedly get stuck. Is this phenomenon specific to autism? Formally we have only conducted interviews with this population, but in another smaller, related project we also spoke to people from the general population with careers that are considered successful in the general society. These people actually voiced similar experiences. Therefore, we hypothesize that this numbing state of being or feeling 'stuck' may be a prevalent phenomenon that needs to be addressed. In this article, we discuss several types of interventive approaches (i.e., language-based talking therapies, affective experiential expressive therapies, physical therapies and systemic therapies), prevention as well as intervention programs, directed at different primary stakeholders, that can complement and enrich each other in an integrative policy, that leads to tailor-made, personalized trajectories of interdisciplinary support to enable people to live satisfying, meaningful, dignified and peaceful lives.
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Affiliation(s)
- Kirstin Greaves-Lord
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, Netherlands
| | - Manna Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Benjamin de Graaff
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Jeanet Landsman
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Klaske van der Weide
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | | | | | | | | | - Emma van Daalen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia’s Children’s Hospital, Rotterdam, Netherlands
| | - Joost van der Linde
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Anne Fleur Stapert
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Jeroen Bekius
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Sigrid Piening
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychiatry, Rob Giel Research Centre, University Medical Center Groningen, Groningen, Netherlands
| | - Annemiek Landlust
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Ingrid D. C. van Balkom
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychiatry, Rob Giel Research Centre, University Medical Center Groningen, Groningen, Netherlands
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Austermann K, Baecker N, Zwart SR, Fimmers R, Stehle P, Smith SM, Heer M. Effects of antioxidant supplementation on bone mineral density, bone mineral content and bone structure in healthy men during 60 days of 6° head-down tilt bed rest: Results from a randomised controlled trial. NUTR BULL 2023; 48:256-266. [PMID: 37106504 DOI: 10.1111/nbu.12619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
Dietary countermeasures to mitigate detrimental spaceflight-induced effects on bone health would alleviate the requirements and the consequences imposed by other types of countermeasures for this risk. We hypothesised that antioxidant supplementation during 60 days of 6° head-down tilt bed rest (HDBR), an analogue of spaceflight, would have a protective effect on bone mineral density (BMD), content (BMC) and bone structure parameters. An exploratory, randomised, controlled, single-blind intervention trial was conducted in a parallel design with 20 healthy male volunteers (age 34 ± 8 y, weight 74 ± 6 kg). The study included 14 days of baseline data collection (BDC) before bed rest, followed by 60 days of HDBR and a 14-day recovery period. Ten subjects in the antioxidant group received a supplement (741 mg/d polyphenols, 2.1 g/d omega-3 fatty acids, 168 mg/d vitamin E and 80 μg/d selenium) daily. Ten subjects in the control group received no supplement. The diet was consistent with dietary reference intakes, individually tailored based on the subject's bodyweight and strictly controlled. We measured whole-body, lumbar spine and femur BMD and BMC, as well as BMD of the cortical and trabecular compartments of the distal radius and tibia, and cortical and trabecular thickness during BDC, HDBR and recovery. Data were analysed using linear mixed models. The supplementation of an antioxidant cocktail did not mitigate the deteriorating effects of HDBR on BMD, BMC and bone structure parameters. Our findings do not support a recommendation for antioxidant supplementation for astronauts.
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Affiliation(s)
- Katharina Austermann
- Institute of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, Bonn, Germany
| | - Natalie Baecker
- IU International University of Applied Sciences, Bad Reichenhall, Erfurt, Germany
| | - Sara R Zwart
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Rolf Fimmers
- Department of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Peter Stehle
- Institute of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, Bonn, Germany
| | - Scott M Smith
- Human Health and Performance Directorate, NASA Lyndon B. Johnson Space Center, Houston, Texas, USA
| | - Martina Heer
- Institute of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, Bonn, Germany
- IU International University of Applied Sciences, Bad Reichenhall, Erfurt, Germany
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14
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McLaughlin KH, Friedman M, Hoyer EH, Kudchadkar S, Flanagan E, Klein L, Daley K, Lavezza A, Schechter N, Young D. The Johns Hopkins Activity and Mobility Promotion Program: A Framework to Increase Activity and Mobility Among Hospitalized Patients. J Nurs Care Qual 2023; 38:164-170. [PMID: 36729980 PMCID: PMC9944180 DOI: 10.1097/ncq.0000000000000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Greater mobility and activity among hospitalized patients has been linked to key outcomes, including decreased length of stay, increased odds of home discharge, and fewer hospital-acquired morbidities. Systematic approaches to increasing patient mobility and activity are needed to improve patient outcomes during and following hospitalization. PROBLEM While studies have found the Johns Hopkins Activity and Mobility Promotion (JH-AMP) program improves patient mobility and associated outcomes, program details and implementation methods are not published. APPROACH JH-AMP is a systematic approach that includes 8 steps, described in this article: (1) organizational prioritization; (2) systematic measurement and daily mobility goal; (3) barrier mitigation; (4) local interdisciplinary roles; (5) sustainable education and training; (6) workflow integration; (7) data feedback; and (8) promotion and awareness. CONCLUSIONS Hospitals and health care systems can use this information to guide implementation of JH-AMP at their institutions.
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Affiliation(s)
- Kevin H. McLaughlin
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Michael Friedman
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Erik H. Hoyer
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Sapna Kudchadkar
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Eleni Flanagan
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Lisa Klein
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Kelly Daley
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Annette Lavezza
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Nicole Schechter
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
| | - Daniel Young
- Johns Hopkins School of Medicine, Baltimore, Maryland (Drs McLaughlin, Hoyer, Kudchadkar, and Schechter, Mr Friedman, and Mss Daley and Lavezza); Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland (Dr Flanagan and Ms Klein); and School of Physical Therapy, University of Nevada Las Vegas, Las Vegas (Dr Young)
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15
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Obara K. Severe Pressure Ulcers in Two Patients With Adrenoleukodystrophy. Cureus 2023; 15:e37669. [PMID: 37081902 PMCID: PMC10110412 DOI: 10.7759/cureus.37669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 04/22/2023] Open
Abstract
Adrenoleukodystrophy (ALD) is a rare X-linked disease that affects the metabolism of very long-chain fatty acids (VLCFAs), leading to cognitive deterioration, progressive spastic paraplegia, sensory disturbance, adrenocortical insufficiency, and bladder and bowel abnormalities. Although the symptoms of ALD correspond to the risk of developing pressure ulcers, a pressure ulcer has never been listed as a complication of ALD. We present two cases of ALD with severe pressure ulcers in the pelvic region and feet. The first case was a 27-year-old male patient with adolescent cerebral-type ALD who had pressure ulcers with bone exposure on the sacral and bilateral greater trochanter region. The second case was a 64-year-old male patient with adrenomyeloneuropathy (AMN) phenotype who had pressure ulcers on the sacral region and both feet. Both patients had VLCFA accumulation and a likely pathogenic variant in the ABCD1 gene, the causative gene of ALD. These cases indicate that ALD patients with immobility and incontinence have a higher risk of developing severe pressure ulcers, which requires the proactive identification of ALD patients and early multidisciplinary intervention for patients and their families to prevent the development of pressure ulcers.
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Affiliation(s)
- Koji Obara
- Neurology, National Hospital Organization Akita National Hospital, Yurihonjo, JPN
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16
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Dimitriadis I, Ambrosini M. Constrained to be (im)mobile? Refugees' and Asylum seekers' practices to integrate in restrictive socio-economic urban contexts in Northern Italy. Front Sociol 2023; 8:1114394. [PMID: 37006632 PMCID: PMC10060620 DOI: 10.3389/fsoc.2023.1114394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
This article comparatively examines forms of (im)mobility among refugees and asylum seekers (RAS) in coping with dispersal process, restrictive migration policies and local socio-economic characteristics in three cities of Northern Italy. Drawing on qualitative data, it sheds light on the everyday forms of (im)mobility of RAS to resist structural barriers limiting their opportunities to access jobs and welfare services. The Results show that people's capacity to overcome barriers depends upon individual characteristics and informal networks, and is shaped by particularities of local contexts. While people's regular legal status is considered an important resource in achieving goals, refugees and holders of international protection often have to adopt (im)mobility practices to access resources in contexts that do not facilitate their integration. This article highlights the inefficiency of integration and reception policies and advances the theoretical debate on the link between being (im)mobile and agency by calling authors to pay more attention to the (in)voluntary nature of spatial (im)mobility. Finally, it shows the ambivalent outcome of (im)mobilities in terms of agency, highlighting the implications for individuals before and during the COVID-19 pandemic.
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Affiliation(s)
- Iraklis Dimitriadis
- Department of Sociology and Social Research, University of Milano-Bicocca, Milan, Italy
| | - Maurizio Ambrosini
- Department of Social and Political Sciences, University of Milano, Milan, Italy
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Iliescu BF, Mancasi VN, Ilie ID, Mancasi I, Costachescu B, Rotariu DI. Design Principle and Proofing of a New Smart Textile Material That Acts as a Sensor for Immobility in Severe Bed-Confined Patients. Sensors (Basel) 2023; 23:2573. [PMID: 36904777 PMCID: PMC10007060 DOI: 10.3390/s23052573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/14/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
The immobility of patients confined to continuous bed rest continues to raise a couple of very serious challenges for modern medicine. In particular, the overlooking of sudden onset immobility (as in acute stroke) and the delay in addressing the underlying conditions are of utmost importance for the patient and, in the long term, for the medical and social systems. This paper describes the design principles and concrete implementation of a new smart textile material that can form the substrate of intensive care bedding, that acts as a mobility/immobility sensor in itself. The textile sheet acts as a multi-point pressure-sensitive surface that sends continuous capacitance readings through a connector box to a computer running a dedicated software. The design of the capacitance circuit ensures enough individual points to provide an accurate description of the overlying shape and weight. We describe the textile composition and circuit design as well as the preliminary data collected during testing to demonstrate the validity of the complete solution. These results suggest that the smart textile sheet is a very sensitive pressure sensor and can provide continuous discriminatory information to allow for the very sensitive, real-time detection of immobility.
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Affiliation(s)
- Bogdan Florin Iliescu
- Department of Neurosurgery, “Gr T Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Vlad Niki Mancasi
- School of Industrial Design and Business Management, Gh. Asachi University of Iasi, 700050 Iasi, Romania
| | | | | | - Bogdan Costachescu
- Department of Neurosurgery, “Gr T Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Daniel Ilie Rotariu
- Department of Neurosurgery, “Gr T Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
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18
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Ram M, Sahu A, Srivastava N, Jhala L, Zala Y, Venkataraman M. Conservation Management of the Endangered Asiatic Lions in Gujarat, India, Using GPS Satellite Telemetry. Animals (Basel) 2022; 13. [PMID: 36611733 DOI: 10.3390/ani13010125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
Endangered Asiatic lions (Panthera leo persica) are found in the Asiatic Lion Landscape, Gujarat, which includes protected areas and a multi-use land matrix. Therefore, monitoring lions' space-use and spatio-temporal location is vital for managing various facets of human-lion interaction. Our study demonstrates how this was achieved by tracking lions using GPS radio-collars, triggering prompt action via an efficient communication network across political and forest administrative boundaries. We monitored the movement of 19 individual lions for 436.5 ± 32 days and also derived the mean daily activity from three-axis accelerometer-based activity-sensing feature of a radio-collar. We also monitored geofence breaches. We proposed that immobility and movement are two aspects that generate management action on the ground. While the movement is related to ranging and dispersal, immobility is a situation related to either the animal's feeding or its health status. From a management standpoint, we discussed the efficacy of the virtual geofence in preventing accidents when lions moved and also presented the advantages of being able to track dispersal through a case study of sub-adult lions. To strengthen our response to lion immobility, we developed a predictive model that specifically highlights an individual lion's health status and makes the alert response more precise. In conclusion, we critically reviewed the capabilities provided by GPS telemetry and provide protocols that help in the conservation management of lions and that will also have a wider application.
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19
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Bouzouina L, Kourtit K, Nijkamp P. Impact of immobility and mobility activities on the spread of COVID‐19: Evidence from European countries. Regional Science Policy & Practice 2022; 14:10.1111/rsp3.12565. [PMCID: PMC9349732 DOI: 10.1111/rsp3.12565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/20/2022] [Accepted: 07/01/2022] [Indexed: 06/19/2023]
Abstract
To limit the spread of COVID‐19, most countries in the world have put in place measures which restrict mobility. The co‐presence of several people in the same place of work, shopping, leisure or transport is considered a favourable vector for the transmission of the virus. However, this hypothesis remains to be verified in the light of the daily data available since the first wave of contamination. Does immobility reduce the spread of the COVID‐19 pandemic? Does mobility contribute to the increase in the number of infections for all activities? This paper applies several pooled mean group–autoregressive distributed lag (PMG–ARDL) models to investigate the impact of immobility and daily mobility activities on the spread of the COVID‐19 pandemic in European countries using daily data for the period from 12 March 2020 to 31 August 2021. The results of the PMG–ARDL models show that immobility and higher temperatures play a significant role in reducing the COVID‐19 pandemic. The increase in mobility activities (grocery, retail, use of transit) is also positively associated with the number of new COVID‐19 cases. The combined analysis with the Granger causality test shows that the relationship between mobility and COVID‐19 goes in both directions, with the exception of grocery shopping, visits to parks and commuting mobility. The former favours the spread of COVID‐19, while the next two have no causal relationship with COVID‐19. The results confirm the role of immobility in mitigating the spread of the pandemic, but call into question the drastic policies of systematically closing all places of activity.
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Affiliation(s)
- Louafi Bouzouina
- LAET, ENTPEUniversity of LyonFrance
- Open UniversityHeerlenThe Netherlands
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20
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Shashikumara S, Purushotham K, Darshan CL, Kalal BS. Characterization of antidepressant activity of Saraca asoca flower (Roxb.) Wilde in mice subjected to acute restraint stress. Am J Transl Res 2022; 14:5014-5023. [PMID: 35958453 PMCID: PMC9360865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Long-term stress and chronic stress events play an important role in the etiology of depression. The study aimed to investigate the antidepressant-like effect of freshly prepared crude ethanolic extract of Saraca asoca flower (ESAF) in a mice model of acute restraint stress. METHODOLOGY Rhamnazin, Myricetin and Quercetin were analytically characterized through liquid chromatography-mass spectrometry and high-performance liquid chromatography from Saraca asoca flower in a 0.1% acetic acid fraction of ethanol. The antidepressant effect was tested by repeated administration of freshly prepared ESAF on mice subjected to repeated and different forms of stress induction for 2 hours every day in the morning and night for seven consecutive days. The antidepressant activity was measured by known behavioral animal models: forced swim test (FST) and tail suspension test (TST). At the end of the experiment, each group of mice was sacrificed by cervical dislocation, followed by an estimation of the biochemical data. RESULTS The oral administration of ESAF in doses of 50, 100, & 250 mg/kg for seven consecutive days gave a significant decrease in the time of immobility (P<0.05) and reversed the depression-like behavior induced by acute restraint methods and behavioral models. ESAF treated groups showed a significant increase in glutathione peroxidase (GSH-PX) activity in the hippocampus of the acutely restrained mice. In addition, ESAF 250 mg/kg reduced plasma corticosterone levels in mice subjected to different forms of acute restraint stress compared to other groups, comparable to the standard imipramine. CONCLUSION Our study showed the antidepressant activity of the ESAF. This effect may be attributed to the presence of antioxidant bioflavonoids namely, Rhamnazin, Myricetin and quercetin. Reduction in the plasma corticosterone levels along with an increase in the antioxidant enzymatic activity such as GSP-PX and SOD in the mice's hippocampus is the proposed molecular hypothesis for its neuroprotective mechanism.
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Affiliation(s)
- Shashikumara Shashikumara
- Department of Pharmacology, Chamarajanagar Institute of Medical SciencesChamarajanagar 571313, Karnataka, India
| | - Krishna Purushotham
- Department of Pharmacology, Chamarajanagar Institute of Medical SciencesChamarajanagar 571313, Karnataka, India
| | - C L Darshan
- Department of Pharmacology, Chamarajanagar Institute of Medical SciencesChamarajanagar 571313, Karnataka, India
| | - Bhuvanesh Sukhlal Kalal
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, College of MedicineLexington Kentucky 40536, USA
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21
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Zemel D, Gritton H, Cheung C, Shankar S, Kramer M, Han X. Dopamine depletion selectively disrupts interactions between striatal neuron subtypes and LFP oscillations. Cell Rep 2022; 38:110265. [PMID: 35045299 DOI: 10.1016/j.celrep.2021.110265] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/20/2021] [Accepted: 12/22/2021] [Indexed: 12/25/2022] Open
Abstract
Dopamine degeneration in Parkinson’s disease (PD) dysregulates the striatal neural network and causes motor deficits. However, it is unclear how altered striatal circuits relate to dopamine-acetylcholine chemical imbalance and abnormal local field potential (LFP) oscillations observed in PD. We perform a multimodal analysis of the dorsal striatum using cell-type-specific calcium imaging and LFP recording. We reveal that dopamine depletion selectively enhances LFP beta oscillations during impaired locomotion, supporting beta oscillations as a biomarker for PD. We further demonstrate that dynamic cholinergic interneuron activity during locomotion remains unaltered, even though cholinergic tone is implicated in PD. Instead, dysfunctional striatal output arises from elevated coordination within striatal output neurons, which is accompanied by reduced locomotor encoding of parvalbumin interneurons and transient pathological LFP high-gamma oscillations. These results identify a pathological striatal circuit state following dopamine depletion where distinct striatal neuron subtypes are selectively coordinated with LFP oscillations during locomotion. Zemel et al. demonstrate that dopamine loss disrupts striatal neural network and enhances local field potential beta oscillations during impaired locomotion. Specifically, striatal projecting neuron activation is abnormally coordinated and accompanied by pathological high-gamma oscillations. While parvalbumin interneurons reduce locomotor encoding, cholinergic interneurons strengthen their interactions with projecting neurons.
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22
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Zhu C, Xu Z, Gu Y, Zheng S, Sun X, Cao J, Song B, Jin J, Liu Y, Wen X, Cheng S, Li J, Wu X. Prediction of Poststroke Urinary Tract Infection Risk in Immobile Patients Using Machine Learning: a observational cohort study. J Hosp Infect 2022:S0195-6701(22)00007-X. [PMID: 35045341 DOI: 10.1016/j.jhin.2022.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/08/2022] [Accepted: 01/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Urinary tract infection (UTI) is one of major nosocomial infections significantly affecting the outcomes of immobile stroke patients. Previous studies have identified several risk factors, but it's still challenging to accurately estimate personal UTI risk. OBJECTIVES We aimed to develop predictive models for UTI risk identification for immobile stroke patients. METHODS Research data were collected from our previous multi-centre study. Derivation cohort included 3982 immobile stroke patients collected from November 1, 2015 to June 30, 2016; external validation cohort included 3837 patients collected from November 1, 2016 to July 30, 2017. 6 machine learning models and an ensemble learning model were derived based on 80% of derivation cohort and effectiveness was evaluated with the remaining 20%. We used Shapley additive explanation values to determine feature importance and examine the clinical significance of prediction models. RESULTS 2.59% (103/3982) patients were diagnosed with UTI in derivation cohort, 1.38% (53/3837) in external cohort. The ensemble learning model performed the best in area under the receiver operating characteristic (ROC) curve in internal validation (82.2%); second best in external validation (80.8%). In addition, the ensemble learning model performed the best sensitivity in both internal and external validation sets (80.9% and 81.1%, respectively). We also identified seven UTI risk factors (pneumonia, glucocorticoid use, female sex, mixed cerebrovascular disease, increased age, prolonged length of stay, and duration of catheterization). CONCLUSIONS Our ensemble learning model demonstrated promising performance. Future work should continue to develop a more concise scoring tool based on machine learning models and prospectively examining the model in practical use, thus improving clinical outcomes.
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Beutler S, Mertens YL, Ladner L, Schellong J, Croy I, Daniels JK. Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients. Eur J Psychotraumatol 2022; 13:2132599. [PMID: 36340007 PMCID: PMC9635467 DOI: 10.1080/20008066.2022.2132599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Neurophysiological models link dissociation (e.g. feeling detached during or after a traumatic event) to hypoarousal. It is currently assumed that the initial passive reaction to a threat may coincide with a blunted autonomic response, which constitutes the dissociative subtype of post-traumatic stress disorder (PTSD). Objective: Within this systematic review we summarize research which evaluates autonomic nervous system activation (e.g. heart rate, blood pressure) and dissociation in PTSD patients to discern the validity of current neurophysiological models of trauma-related hypoarousal. Method: Of 553 screened articles, 28 studies (N = 1300 subjects) investigating the physiological response to stress provocation or trauma-related interventions were included in the final analysis. Results: No clear trend exists across all measured physiological markers in trauma-related dissociation. Extracted results are inconsistent, in part due to high heterogeneity in experimental methodology. Conclusion: The current review is unable to provide robust evidence that peri- and post-traumatic dissociation are associated with hypoarousal, questioning the validity of distinct psychophysiological profiles in PTSD.
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Affiliation(s)
- Sarah Beutler
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Yoki L Mertens
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Liliana Ladner
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany.,Department of Clinical Psychology, Friedrich-Schiller University Jena, Jena, Germany
| | - Judith K Daniels
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
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24
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Liu H, Song B, Jin J, Liu Y, Wen X, Cheng S, Nicholas S, Maitland E, Wu X, Zhu D, Chen W. Nutritional Risk, Health Outcomes, and Hospital Costs Among Chinese Immobile Older Inpatients: A National Study. Front Nutr 2021; 8:758657. [PMID: 34957178 PMCID: PMC8703034 DOI: 10.3389/fnut.2021.758657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/09/2021] [Indexed: 12/07/2022] Open
Abstract
Purpose: Evidence of the impact of nutritional risk on health outcomes and hospital costs among Chinese older inpatients is limited. Relatively few studies have investigated the association between clinical and cost outcomes and nutritional risk in immobile older inpatients, particularly those with neoplasms, injury, digestive, cardiac, and respiratory conditions. Methods: This China-wide prospective observational cohort study comprised 5,386 immobile older inpatients hospitalized at 25 hospitals. All patients were screened for nutritional risk using the Nutrition Risk Screening (NRS 2002). A descriptive analysis of baseline variables was followed by multivariate analysis (Cox proportional hazards models and generalized linear model) to compare the health and economic outcomes, namely, mortality, length of hospital stay (LoS), and hospital costs associated with a positive NRS 2002 result. Results: The prevalence of a positive NRS 2002 result was 65.3% (n = 3,517). The prevalence of “at-risk” patients (NRS 2002 scores of 3+) was highest in patients with cardiac conditions (31.5%) and lowest in patients with diseases of the respiratory system (6.9%). Controlling for sex, age, education, type of insurance, smoking status, the main diagnosed disease, and Charlson comorbidity index (CCI), the multivariate analysis showed that the NRS 2002 score = 3 [hazard ratio (HR): 1.376, 95% CI: 1.031–1.836] were associated with approximately a 1.5-fold higher likelihood of death. NRS 2002 scores = 4 (HR: 1.982, 95% CI: 1.491–2.633) and NRS scores ≥ 5 (HR: 1.982, 95% CI: 1.498–2.622) were associated with a 2-fold higher likelihood of death, compared with NRS 2002 scores <3. An NRS 2002 score of 3 (percentage change: 16.4, 95% CI: 9.6–23.6), score of 4 (32.4, 95% CI: 24–41.4), and scores of ≥ 5 (36.8, 95% CI 28.3–45.8) were associated with a significantly (16.4, 32.4, and 36.8%, respectively) higher likelihood of increased LoS compared with an NRS 2002 scores <3. The NRS 2002 score = 3 group (17.8, 95% CI: 8.6–27.7) was associated with a 17.8%, the NRS 2002 score = 4 group (31.1, 95% CI: 19.8–43.5) a 31.1%, and the NRS 2002 score ≥ 5 group (44.3, 95% CI: 32.3–57.4) a 44.3%, higher likelihood of increased hospital costs compared with a NRS 2002 scores <3 group. Specifically, the most notable mortality-specific comorbidity and LoS-specific comorbidity was injury, while the most notable cost-specific comorbidity was diseases of the digestive system. Conclusions: This study demonstrated the high burden of undernutrition at the time of hospital admission on the health and hospital cost outcomes for older immobile inpatients. These findings underscore the need for nutritional risk screening in all Chinese hospitalized patients, and improved diagnosis, treatment, and nutritional support to improve immobile patient outcomes and to reduce healthcare costs.
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Affiliation(s)
- Hongpeng Liu
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Baoyun Song
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yilan Liu
- Department of Nursing, Wuhan Union Hospital, Wuhan, China
| | - Xianxiu Wen
- Department of Nursing, Sichuan Provincial People's Hospital, Chengdu, China
| | - Shouzhen Cheng
- Department of Nursing, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Eveleigh, NSW, Australia.,School of Economics and School of Management, Tianjin Normal University, Tianjin, China.,Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, China.,Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Xinjuan Wu
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Wei Chen
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital Beijing, China
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25
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Alwasel A, Alossimi B, Alsadun M, Alhussaini K. Bedsores Management: Efficiency Simulation of a New Mattress Design. Healthcare (Basel) 2021; 9:1701. [PMID: 34946427 DOI: 10.3390/healthcare9121701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
Bedsores, also known as pressure ulcers, are wounds caused by the applied external force (pressure) on body segments, thereby preventing blood supply from delivering the required elements to the skin tissue. Missing elements hinder the skin’s ability to maintain its health. It poses a significant threat to patients that have limited mobility. A new patented mattress design and alternative suggested designs aimed to reduce pressure are investigated in this paper for their performance in decreasing pressure. A simulation using Ansys finite element analysis (FEA) is carried out for comparison. Three-dimensional models are designed and tested in the simulation for a mattress and human anthropometric segments (Torso and Hip). All designs are carried out in solidworks. Results show that the original design can redistribute the pressure and decrease it up to 17% less than the normal mattress. The original design shows better ability to decrease the absolute amount of pressure on the body. However, increasing the surface area of the movable parts results in less pressure applied to the body parts. Thus, this work suggests changing the surface area of the cubes from 25 to 100 cm2.
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26
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Lam K, Kwan JSK, Kwan CW, Chi I. Factors Associated with Development of New Joint Contractures in Long-Term Care Residents. J Am Med Dir Assoc 2021; 23:92-97. [PMID: 34175292 DOI: 10.1016/j.jamda.2021.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Limb contractures are associated with poor outcomes and quality of life in long-term care (LTC) residents. This study examined the rate of developing new joint contracture in the LTC residents and associated risk factors to formulate effective interventions in this critical but understudied area. DESIGN This is an observational study with data obtained from the Hong Kong Longitudinal Study on LTC Residents between 2005 and 2016. SETTING AND PARTICIPANTS Trained assessors (nurses, social workers, and therapists) used the Minimum Data Set Resident Assessment Instrument (MDS-RAI 2.0) to collect the data of the residents from 9 residential LTC facilities. MEASURES Limb contractures were defined as a functional limitation in the range of motion involving the upper or lower limbs. Primary outcomes included annual prevalence of joint contractures and factors that were associated with the development of new joint contractures. RESULTS We analyzed the data for 1914 older residents (674 males, mean age 83.4 years). During the first 5 years since admission, the annual prevalence of upper limb contractures increased from 29.8% to 36.5%, and lower limb contractures increased from 41.5% to 57.4%. Overall, the increment of the prevalence rate of joint contractures per year ranged from 0.7% to 3.2% for the upper limbs and 0.3% to 6.0% per year for the lower limbs. Impaired mobility, presence of neurologic diseases, and older age were the leading independent risk factors for the development of new joint contractures. CONCLUSIONS AND IMPLICATIONS Joint contractures are highly prevalent among residents admitted to the LTC facilities, and many residents develop new contractures during the first 5 years of their admission. Immobility appears to be the main modifiable risk factor. Further studies are needed to identify potential strategies to prevent new contractures in this vulnerable group.
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Affiliation(s)
- Kuen Lam
- Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong, China.
| | - Joseph S K Kwan
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Chi Wai Kwan
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China
| | - Iris Chi
- Suzanne Dwork-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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27
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Austermann K, Baecker N, Zwart SR, Fimmers R, Frippiat JP, Stehle P, Smith SM, Heer M. Antioxidant Supplementation Does Not Affect Bone Turnover Markers During 60 Days of 6° Head-Down Tilt Bed Rest: Results from an Exploratory Randomized Controlled Trial. J Nutr 2021; 151:1527-1538. [PMID: 33831949 DOI: 10.1093/jn/nxab036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/02/2020] [Accepted: 01/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Immobilization and related oxidative stress are associated with bone loss. Antioxidants like polyphenols, omega-3 fatty acids, vitamins, and micronutrients may mitigate these negative effects on bone metabolism through scavenging of free radicals. OBJECTIVES We hypothesized that antioxidant supplementation during 60 days of 6° head-down tilt bed rest (HDBR) would reduce bone resorption and increase bone formation compared to nonsupplemented controls. METHODS This exploratory randomized, controlled, single-blind intervention study conducted in a parallel design included 20 healthy male volunteers (age, 34 ± 8 years; weight, 74 ± 6 kg). The study consisted of a 14-day adaptation phase [baseline data collection (BDC)], followed by 60 days of HDBR and a 14-day recovery period (R). In the antioxidant group, volunteers received an antioxidant cocktail (741 mg/d polyphenols, 2.1 g/d omega-3 fatty acids, 168 mg/d vitamin E, and 80 μg/d selenium) with their daily meals. In the control group, volunteers received no supplement. Based on their body weight, all volunteers received an individually tailored and strictly controlled diet, consistent with DRIs. We analyzed biomarkers of calcium homeostasis, bone formation, and bone resorption during BDC, HDBR, and R, as well as for 30 days after the end of HDBR. Data were analyzed by linear mixed models. RESULTS The antioxidant supplement did not affect serum calcium, parathyroid hormone, urinary C-telopeptide of type I collagen (CTX), urinary N-telopeptide of type I collagen, serum β-C-telopeptide of type I collagen (β-CTX), bone alkaline phosphatase, aminoterminal propeptide of type I collagen, osteocalcin, or urinary calcium excretion. In both groups, typical bed rest-related changes were observed. CONCLUSIONS Supplementation of an antioxidant cocktail to a diet matching the DRIs did not affect bone resorption or formation during 60 days of HDBR in healthy young men. This trial was registered at clinicaltrials.gov as NCT03594799.
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Affiliation(s)
- Katharina Austermann
- Nutritional Physiology, Institute of Nutritional and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Natalie Baecker
- IUBH International University of Applied Sciences, Bad Reichenhall, Germany
| | - Sara R Zwart
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Rolf Fimmers
- Department of Medical Biometry, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Jean-Pol Frippiat
- Stress, Immunity, Pathogens Laboratory, Lorraine University, Nancy, France
| | - Peter Stehle
- Nutritional Physiology, Institute of Nutritional and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Scott M Smith
- Human Health and Performance Directorate, National Aeronautics and Space Administration Johnson Space Center, Houston, TX, USA
| | - Martina Heer
- Nutritional Physiology, Institute of Nutritional and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.,IUBH International University of Applied Sciences, Bad Reichenhall, Germany
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Abstract
In this essay, I explain how geography offers important ideas to better understand what is happening to our sense of place during the COVID‐19 crisis, complementing the scientific understandings provided by epidemiologists and public health experts. I explain how geographical ideas relating to place and mobility can help us make sense of our current situation and consider what we might be feeling. These geographical ideas also provide us with important political tools to identify the new forms of inequality and hardship that are unfolding, prompting questions about how we should collectively respond to shape the future of place.
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Affiliation(s)
- David Bissell
- School of GeographyThe University of MelbourneParkvilleVictoriaAustralia
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29
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Sartori M, Favaretto E, Cosmi B. Relevance of immobility as a risk factor for symptomatic proximal and isolated distal deep vein thrombosis in acutely ill medical inpatients. Vasc Med 2021; 26:542-548. [PMID: 33813966 DOI: 10.1177/1358863x21996825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Immobility is a well-recognized risk factor for deep vein thrombosis (DVT) in surgical patients, whereas the level of DVT risk conferred by immobility is less defined in patients on medical wards. The aim of this study was to establish whether immobility and its duration are associated with the risk of DVT in acutely ill medical inpatients. We conducted a cohort study in acutely ill medical inpatients. Patients underwent whole leg ultrasound for suspected lower extremity DVT and were divided into two groups according to presence or absence of immobility, defined as total bed rest or sedentary without bathroom privileges. The endpoint was the detection of proximal DVT or isolated distal DVT (IDDVT). Among the 252 acutely ill medical inpatients with immobility (age 82.6 ± 10.3 years, female 63.9%), ultrasound showed 36 (14.3%) proximal DVTs and 39 (15.5%) IDDVTs, while there were 11 (4.4%) proximal DVTs and 26 (10.5%) IDDVTs among the 248 inpatients without immobility (age 73.6 ± 14.2 years, female 54.8%). The risk of proximal DVT was higher in immobile than in mobile patients (OR 3.59, 95% CI: 1.78-7.23, p = 0.0001), whereas the risk of IDDVT was similar between the two groups (OR 1.56, 95% CI: 0.92-2.66, p = 0.111). During the first 3 days of hospitalization, the frequency of all DVTs was similar in patients with and without immobility, but it was 0.26 ± 0.03 vs 0.18 ± 0.03, respectively, after 4 days. In conclusion, immobility for more than 3 days is a risk factor for proximal DVT in acutely ill medical inpatients.
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Affiliation(s)
- Michelangelo Sartori
- Division of Angiology and Blood Coagulation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elisabetta Favaretto
- Division of Angiology and Blood Coagulation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Benilde Cosmi
- Division of Angiology and Blood Coagulation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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30
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Wiedl A, Förch S, Fenwick A, Mayr E. Incidence, Risk-Factors and Associated Mortality of Complications in Orthogeriatric Co-Managed Inpatients. Geriatr Orthop Surg Rehabil 2021; 12:2151459321998314. [PMID: 33786204 PMCID: PMC7961710 DOI: 10.1177/2151459321998314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/05/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction: Pneumonia, thromboembolic and ischemic events, urinary tract infections (UTI), delirium and acute kidney injury (AKI) are common complications during the treatment of fragility fractures. In a 2 years-follow-up we determined the according incidence and risk factors of these and other complications in orthogeriatric inward patients, as well as the respective associated mortality. Methods: All patients treated on an orthogeriatric co-managed ward over the course of a year were included. Besides injury, therapy and geriatric assessment parameters, we evaluated the inward incidence of common complications. In a 2 years-follow-up the associated death rates were aquired. SPSS (IBM) was used to determine the importance of risk factors predisposing to the respective occurrence of a complication and accordingly determine it’s impact on the patients’ 1- and 2-years-mortality. Results: 830 orthogeriatric patients were initially assessed with a remaining follow-up cohort of 661 (79.6%). We observed very few cases of thrombosis (0.6%), pulmonary embolism (0.5%), apoplex (0.5%) and myocardial infarction (0.8%). Pneumonia was seen in 42 (5.1%), UTI in 85 (10.2%), delirium in 186 (22.4%) and AKI in 91 (11.0%) patients. Consistently ADL on admission was found to be a relevant risk factor in the development of each complication. After adjustment only AKI showed a significant increased mortality risk of 1.60 (95%CI:1.086-2.350). Discussion: In our fracture-independent assessment of complications in the orthogeriatric treatment of inward patients we’ve seen very rare cases of cardiac and thrombotic complications. Typical fragility-fracture associated common events like pneumonia, UTI, delirium and AKI were still more incidental. No complication except AKI was associated to significant increased mortality risk. Conclusions: The relevance of orthogeriatric care in prevention and outcome of inward complications seems promising, needing still more controlled studies, evaluating not just hip fracture patients but more diverse groups. Consensus is needed in the scholar evaluation of orthogeriatric complications.
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Affiliation(s)
- Andreas Wiedl
- Universitätsklinikum Augsburg, Abteilung für Unfallchirurgie, Orthopädie, Plastische und Handchirurgie, Augsburg, Germany
| | - Stefan Förch
- Universitätsklinikum Augsburg, Abteilung für Unfallchirurgie, Orthopädie, Plastische und Handchirurgie, Augsburg, Germany
| | - Annabel Fenwick
- Universitätsklinikum Augsburg, Abteilung für Unfallchirurgie, Orthopädie, Plastische und Handchirurgie, Augsburg, Germany
| | - Edgar Mayr
- Universitätsklinikum Augsburg, Abteilung für Unfallchirurgie, Orthopädie, Plastische und Handchirurgie, Augsburg, Germany
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Kelman I, Ayeb-Karlsson S, Rose-Clarke K, Prost A, Ronneberg E, Wheeler N, Watts N. A review of mental health and wellbeing under climate change in small island developing states (SIDS). Environ Res Lett 2021; 16:033007. [PMID: 34149865 PMCID: PMC8208624 DOI: 10.1088/1748-9326/abe57d] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 05/03/2023]
Abstract
Small island developing states (SIDS) are often at the forefront of climate change impacts, including those related to health, but information on mental health and wellbeing is typically underreported. To help address this research lacuna, this paper reviews research about mental health and wellbeing under climate change in SIDS. Due to major differences in the literature's methodologies, results, and analyses, the method is an overview and qualitative evidence synthesis of peer-reviewed publications. The findings show that mental health and wellbeing in the context of climate change have yet to feature prominently and systematically in research covering SIDS. It seems likely that major adverse mental health and wellbeing impacts linked to climate change impacts will affect SIDS peoples. Similar outcomes might also emerge when discussing climate change related situations, scenarios, and responses, irrespective of what has actually happened thus far due to climate change. In the context of inadequate health systems and stigmatisation of mental health diagnoses and treatments, as tends to occur globally, climate change narratives might present an opening for conversations about addressing mental health and wellbeing issues for SIDS.
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Affiliation(s)
- Ilan Kelman
- University College London (UCL), London, United Kingdom
- University of Agder, 4630 Kristiansand, Norway
| | - Sonja Ayeb-Karlsson
- University of Sussex, Brighton BN1 9RH, United Kingdom
- United Nations University Institute for Environment and Human Security, D-53113 Bonn, Germany
| | | | - Audrey Prost
- University College London (UCL), London, United Kingdom
| | - Espen Ronneberg
- Secretariat of the Pacific Regional Environment Programme (SPREP), Apia, Samoa
| | - Nicola Wheeler
- Consultant (World Health Organization), Associate (Outsight International), London, United Kingdom
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32
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Thomassen JAK. The roles of family and friends in the immobility decisions of university graduates staying in a peripheral urban area in the Netherlands. Popul Space Place 2021; 27:e2392. [PMID: 33790695 PMCID: PMC7988607 DOI: 10.1002/psp.2392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 05/26/2023]
Abstract
Highly educated individuals constitute great assets for regional development and economic growth. Nevertheless, young university graduates are relatively geographically mobile and less likely to stay in peripheral regions. Based on semi-structured, life-calendar interviews, this study explored the immobility decisions of graduates who have stayed in a peripheral urban area in the Netherlands where they completed their university education. The study specifically focused on the roles of family and friends in the staying processes of these young adults. The results indicate that the decision to stay was frequently and consciously re-evaluated by some, whereas for others, it resulted from a 'lack of triggers' for moving elsewhere. Notably, the interviews revealed that family and friends act as more than motives for staying or deterrents to migration. On various occasions, family and friends had played crucial roles as advisors, influencers, triggers, exemplars and facilitators in the staying processes of highly educated young adults.
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Affiliation(s)
- Jonne A. K. Thomassen
- Population Research Centre, Faculty of Spatial SciencesUniversity of GroningenGroningenThe Netherlands
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33
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Capaldi N, Kao KT, MacDonald R, Grainger KC, Joseph S, Shepherd S, Mason A, Wong SC. Feasibility of Dual Energy X-Ray Absorptiometry Based Images for Measurement of Height, Sitting Height, and Leg Length in Children. J Clin Densitom 2020; 23:472-481. [PMID: 30098887 DOI: 10.1016/j.jocd.2018.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Interpretation of pediatric bone mineral density by dual energy absorptiometry (DXA) requires adjustment for height (Ht). This is often not easily obtainable in nonambulant subjects. AIMS To investigate the feasibility of using DXA images to evaluate measurements of Ht, sitting height (SH), and leg length (LL). METHODOLOGY A total of 2 observers performed measurements of Ht, SH, and LL on 3 separate occasion using DXA digital images in 125 children. Intraclass correlation and relative technical error of measurement (rTEM) were performed to assess reliability of repeated measurements. In 25 children, Ht and SH were measured in clinic on the same day and Bland-Altman analysis was performed to compare DXA measured Ht, SH, LL with clinic measurements for these 25 children. RESULTS Intraclass correlation for DXA based Ht, SH, and LL measurements ranged from 0.996 to 0.998 (p < 0.0001). rTEM of Ht, SH, and LL for observer 1 was 0.0016%, 0.002%, and 0.0034%, respectively. rTEM of Ht, SH, and LL between observer 1 and 2 was 0.0047%, 0.0049%, and 0.0087%, respectively. Mean difference between clinic and DXA measurements from Bland-Altman plots were +0.57 cm (95% confidence interval [CI] -0.54 to +1.68) for Ht, +1.33cm (-1.60 to +4.24) for SH, and -0.76cm (-3.88 to +2.37) for LL. CONCLUSIONS Our study demonstrated for the first time that Ht, SH, and LL in children can be measured very precisely using DXA images. Ht can be measured accurately. We believe this may be a convenient method to obtain Ht measurements to allow size adjustment of DXA bone mineral density in immobile children with chronic conditions.
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Affiliation(s)
- N Capaldi
- School of Medicine, University of Glasgow, Glasgow, United Kingdom; Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - K T Kao
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - R MacDonald
- School of Medicine, University of Glasgow, Glasgow, United Kingdom; Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - K C Grainger
- Department of Sports Science, London Metropolitan University, London
| | - S Joseph
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow; Paediatric Neurosciences Research Group, Royal Hospital for Children, Glasgow, United Kingdom
| | - S Shepherd
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - A Mason
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - S C Wong
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow.
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Pereira M, Swash M, de Carvalho M. Immobility and F-waves: Impact on lower motor neuron excitability. Muscle Nerve 2020; 61:480-484. [PMID: 31998973 DOI: 10.1002/mus.26817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/12/2020] [Accepted: 01/21/2020] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Immobility of the upper limbs has been associated with reduction of F-wave frequency. However, there are no similar studies on lower limb (LL) F-waves. We investigated the impact of LL rest on F-wave and H-reflex parameters. METHODS The LLs of 14 healthy participants were studied after 90 minutes rest. F-waves (frequency, latencies, chronodispersion, and mean amplitude) and H-reflexes (latency and recruitment curve) were investigated bilaterally. In seven participants the protocol was repeated, but the temperature of one limb was reduced. RESULTS Immobility only changed F-wave latencies, which increased significantly (mean value of 2 ms, P < .01). Limb cooling did not influence results. DISCUSSION Contrary to what occurred in cervical lower motor neurons (LMN), LL LMNs did not show a reduced F-wave response to immobility, but their latency increased significantly. This could have been due to reduced Renshaw inhibition of small LMNs, thus facilitating their response to antidromic stimulation and causing delayed late responses.
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Affiliation(s)
- Mariana Pereira
- Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, Lisbon, Portugal
| | - Michael Swash
- Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, Lisbon, Portugal.,Department of Neurology and Neuroscience, Barts and the London School of Medicine, Queen Mary University of London and Royal London Hospital, United Kingdom
| | - Mamede de Carvalho
- Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
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Kim G, Kim Y, Yoon S, Kim S, Yi SS. Sleep-inducing effect of Passiflora incarnata L. extract by single and repeated oral administration in rodent animals. Food Sci Nutr 2020; 8:557-566. [PMID: 31993179 PMCID: PMC6977488 DOI: 10.1002/fsn3.1341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/29/2019] [Accepted: 10/05/2019] [Indexed: 11/28/2022] Open
Abstract
Social cost of insomnia in modern society is gradually increasing. Due to various social phenomena and lifestyles that take away the opportunity of good quality of sleep, problems of insomnia cannot be easily figured out. Prescription of sleeping pills for insomnia patients can cause other inconveniences due to their side effects beyond their intended purposes. On the other hand, Passiflora incarnata L. (PI) has been widely used in South America for several centuries, showing effectiveness for sleep, sedation, anxiety, and so on in the civilian population. However, reports on the treatment efficacy of this herbal medicinal plant for insomnia patients through standardization as a sleeping agent have been very rare. Therefore, we obtained leaves and fruits of PI (8:2 by weight) as powder to prepare an extract. It was then applied to C6 rat glioma cells to quantitate mRNA expression levels of GABA receptors. Its sleep-inducing effect was investigated using experimental animals. PI extract (6 μg/ml) significantly decreased GABA receptors at 6 hr after treatment. Immobility time and palpebral closing time were significantly increased after single (500 mg/kg) or repeated (250 mg/kg) oral administration. In addition, blood melatonin levels were significantly increased in PI extract-treated animals after both single and repeated administrations. These results were confirmed through several repeated experiments. Taken together, these results confirmed that PI extract had significant sleep-inducing effects in cells and animals, suggesting that PI extract might have potential for treating human insomnia.
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Affiliation(s)
- Gwang‐Ho Kim
- Department of Biomedical Laboratory ScienceCollege of Medical SciencesSoonchunhyang UniversityAsanKorea
| | - Yehlim Kim
- Department of Biomedical Laboratory ScienceCollege of Medical SciencesSoonchunhyang UniversityAsanKorea
| | - Sunmi Yoon
- Department of Biomedical Laboratory ScienceCollege of Medical SciencesSoonchunhyang UniversityAsanKorea
| | - Sung‐Jo Kim
- Department of BiotechnologyHoseo UniversityAsanKorea
| | - Sun Shin Yi
- Department of Biomedical Laboratory ScienceCollege of Medical SciencesSoonchunhyang UniversityAsanKorea
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Ayeb-Karlsson S, Kniveton D, Cannon T, van der Geest K, Ahmed I, Derrington EM, Florano E, Opondo DO. I will not go, I cannot go: cultural and social limitations of disaster preparedness in Asia, Africa, and Oceania. Disasters 2019; 43:752-770. [PMID: 31475392 DOI: 10.1111/disa.12404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
While much work has been invested in addressing the economic and technical basis of disaster preparedness, less effort has been directed towards understanding the cultural and social obstacles to and opportunities for disaster risk reduction. This paper presents local insights from five different national settings into the cultural and social contexts of disaster preparedness. In most cases, an early warning system was in place, but it failed to alert people to diverse environmental shocks. The research findings show that despite geographical and typological differences in these locations, the limitations of the systems were fairly similar. In Kenya, people received warnings, but from contradictory systems, whereas in the Philippines and on the island of Saipan, people did not understand the messages or take them seriously. In Bangladesh and Nepal, however, a deeper cultural and religious reasoning serves to explain disasters, and how to prevent them or find safety when they strike.
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Affiliation(s)
- Sonja Ayeb-Karlsson
- Lecturer in Global Health at the Brighton and Sussex Medical School, University of Sussex, United Kingdom and a Senior Researcher at the United Nations University's Institute for Environment and Human Security, Germany
| | - Dominic Kniveton
- Professor of Climate Change and Society at the University of Sussex, United Kingdom
| | - Terry Cannon
- Research Fellow at the Institute of Development Studies, United Kingdom
| | - Kees van der Geest
- Head of Section at the United Nations University's Institute for Environment and Human Security, Germany
| | - Istiakh Ahmed
- Programme Coordinator at the International Centre for Climate Change and Development, Bangladesh
| | - Erin M Derrington
- Environmental Consultant and the Lead Planner at the CNMI (Commonwealth of the Northern Mariana Islands) Office of Planning and Development, United States
| | - Ebinezer Florano
- Associate Professor at the University of the Philippines, the Philippines
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Buso A, Comelli M, Picco R, Isola M, Magnesa B, Pišot R, Rittweger J, Salvadego D, Šimunič B, Grassi B, Mavelli I. Mitochondrial Adaptations in Elderly and Young Men Skeletal Muscle Following 2 Weeks of Bed Rest and Rehabilitation. Front Physiol 2019; 10:474. [PMID: 31118897 PMCID: PMC6504794 DOI: 10.3389/fphys.2019.00474] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/04/2019] [Indexed: 12/21/2022] Open
Abstract
The aim of the study was to evaluate the expression levels of proteins related to mitochondrial biogenesis regulation and bioenergetics in vastus lateralis muscle biopsies from 16 elderly and 7 young people subjected to 14 days of bed-rest, causing atrophy, and subsequent 14 days of exercise training. Based on quantitative immunoblot analyses, in both groups a reduction of two key regulators of mitochondrial biogenesis/remodeling and activity, namely PGC-1α and Sirt3, was revealed during bed-rest, with a subsequent up-regulation after rehabilitation, indicating an involvement of PGC-1α-Sirt3 axis in response to the treatments. A difference was observed comparing the young and elderly subjects as, for both proteins, the abundance in the elderly was more affected by immobility and less responsive to exercise. The expression levels of TOM20 and Citrate Synthase, assayed as markers of outer mitochondrial membrane and mitochondrial mass, showed a noticeable sensitivity in the elderly group, where they were affected by bed-rest and rehabilitation recalling the pattern of PGC-1α. TOM20 and CS remained unchanged in young subjects. Single OXPHOS complexes showed peculiar patterns, which were in some cases dissimilar from PGC-1α, and suggest different influences on protein biogenesis and degradation. Overall, exercise was capable to counteract the effect of immobility, when present, except for complex V, which was markedly downregulated by bed-rest, but remained unaffected after rehabilitation, maybe as result of greater extent of degradation processes over biogenesis. Phosphorylation extent of AMPK, and its upstream activator LKB1, did not change after bed-rest and rehabilitation in either young or elderly subjects, suggesting that the activation of energy-sensing LKB1-AMPK signaling pathway was “missed” due to its transient nature, or was not triggered under our conditions. Our study demonstrates that, as far as the expression of various proteins related to mitochondrial biogenesis/remodeling, adaptations to bed-rest and rehabilitation in the two populations were different. The impact of bed-rest was greater in the elderly subjects, where the pattern (decrease after bed rest and recovery following rehabilitation) was accompanied by changes of mitochondrial mass. Modifications of protein abundance were matched with data obtained from gene expression analyses of four public human datasets focusing on related genes.
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Affiliation(s)
- Alessia Buso
- Department of Medicine, University of Udine, Udine, Italy
| | - Marina Comelli
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Joern Rittweger
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany.,Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Desy Salvadego
- Department of Medicine, University of Udine, Udine, Italy
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy.,Institute of Bioimaging and Molecular Physiology, National Research Council, Milan, Italy
| | - Irene Mavelli
- Department of Medicine, University of Udine, Udine, Italy.,INBB Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
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Jaul E, Factor H, Karni S, Schiffmiller T, Meiron O. Spasticity and dementia increase the risk of pressure ulcers. Int Wound J 2019; 16:847-851. [PMID: 30895715 DOI: 10.1111/iwj.13110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 02/20/2019] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to identify and characterise the association between the prevalence of pressure ulcers, spasticity levels, and advanced dementia in disable elderly patients. Data were obtained from the patient medical files. Patients were hospitalised in the geriatric skilled nursing department. A total of 40 frail elderly patients, bedbound and suffering from advanced chronic diseases, advanced dementia, and high-grade pressure ulcers, were examined. Pressure ulcer grades and spasticity in advanced dementia versus non-dementia patients were evaluated. Logistic regression indicated that only advanced dementia and spasticity were significantly associated with the development of pressure ulcers versus those without dementia or without spasticity. Patients with advanced dementia displayed a significantly higher prevalence of severe spasticity. In multivariate logistic regression analyses, spasticity was significantly associated with pressure ulcers. The strong association of spasticity with the onset of pressure ulcers in advanced dementia should encourage clinicians to implement preventative measures to delay the onset of pressure ulcers.
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Affiliation(s)
- Efraim Jaul
- Geriatric Skilled Nursing Department, Herzog Medical Center, Hebrew University, Jerusalem, Israel
| | - Hagai Factor
- Electrophysiology and Neurocognition Lab, Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
| | - Sharon Karni
- Occupational Therapy Department, Herzog Medical Center, Jerusalem, Israel
| | | | - Oded Meiron
- Electrophysiology and Neurocognition Lab, Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
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Santos MF, Bastos AF, Oliveira JM, Figueira I, Gleiser S, Pereira MG, Volchan E, Erthal FS. Hands Up! Atypical Defensive Reactions in Heavy Players of Violent Video Games When Exposed to Gun-Attack Pictures. Front Psychol 2019; 10:191. [PMID: 30804849 PMCID: PMC6370668 DOI: 10.3389/fpsyg.2019.00191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/21/2019] [Indexed: 11/13/2022] Open
Abstract
Threatening cues and surrounding contexts trigger specific defensive response patterns. Posturography, a technique for measuring postural strategies, has been used to evaluate motor defensive reactions in humans. When exposed to gun pointed pictures, humans were shown to exhibit an immobility reaction. Short and long-term exposure to violent video games was shown to be a causal risk factor for increased violent and aggressive behavior. Assaultive violence with a gun is a major trigger for motor defensive reactions, and post-traumatic stress disorder (PTSD) is the most characteristic psychiatric sequelae. Recent studies point to links between PTSD symptoms and emotional shortfalls in non-clinical trauma-exposed samples. The present study investigated defensive reactions to gun threat and PTSD symptoms in heavy players of violent video games compared to non-players. Male university students were screened according to use of violent video games and divided in three groups: non-players, moderate players, and heavy players. Stimuli were pictures depicting a man pointing a gun directed at the participant. In matched control pictures, non-lethal objects replaced the gun. Posturography was recorded and PTSD symptoms were assessed. When exposed to the threat pictures, non-players exhibited the expected reduction in amplitude of body sway (immobility), heavy players presented atypical augmented amplitude of body sway, and moderate players showed intermediate reactivity. Heavy players presented a significant distinct reaction compared to non-players. They also scored significantly higher in PTSD symptoms than non-players. Disadvantageous defensive reactions and higher vulnerability to PTSD symptoms, revealed in the present study, add to other shortcomings for heavy players.
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Affiliation(s)
- Maria Fernanda Santos
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline F Bastos
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jose M Oliveira
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ivan Figueira
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sonia Gleiser
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mirtes G Pereira
- Biomedical Institute, Universidade Federal Fluminense, Niterói, Brazil
| | - Eliane Volchan
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fátima S Erthal
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Luryi AL, Lawrence J, LaRouere M, Babu S, Bojrab DI, Zappia J, Sargent EW, Schutt CA. Treatment of Patients With Benign Paroxysmal Positional Vertigo and Severe Immobility Using the Particle Repositioning Chair: A Retrospective Cohort Study. Ann Otol Rhinol Laryngol 2018; 127:390-394. [PMID: 29732909 DOI: 10.1177/0003489418771988] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To report treatment of benign paroxysmal positional vertigo (BPPV) in patients unable to undergo traditional canalith repositioning maneuvers (CRMs) using a particle repositioning chair (PRC). METHODS A retrospective chart review was conducted at a single high-volume otology practice of patients diagnosed with BPPV from 2007 to 2017 with immobility prohibiting use of traditional CRMs. Patients were diagnosed and treated using a PRC, and outcome measures including resolution, recurrence, and number of treatment visits were recorded. RESULTS A total of 34 patients meeting criteria were identified, 24 of whom had cervical spine disease and 10 of whom had other prohibitive immobility. Symptoms were present for between 5 days and 11 years at presentation, with mean and median of 552 and 90 days, respectively. Symptoms resolved in 68% of patients and recurred in 13% of those patients. Most patients required 1 treatment visit. CONCLUSIONS Successful treatment of patients with BPPV and concomitant immobility prohibiting traditional CRMs is reported using the PRC. Benign paroxysmal positional vertigo in the setting of immobility is an indication for treatment with a PRC if available.
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Affiliation(s)
- Alexander L Luryi
- 1 Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Juliana Lawrence
- 1 Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael LaRouere
- 2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA
| | - Seilesh Babu
- 2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA
| | - Dennis I Bojrab
- 2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA
| | - John Zappia
- 2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA
| | - Eric W Sargent
- 2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA
| | - Christopher A Schutt
- 2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA
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Abstract
OBJECTIVE Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia. METHODS The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors. RESULTS The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95% confidence interval = 2.0-10.6, p < .01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values < .01, except for deep venous thrombosis, p = .04 in the multiple linear regression analysis). CONCLUSIONS Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.
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Nissen S, Purssell E, Shaw K, Bailey C, Efstathiou N, Dunford C. Impaired mobility associated with an increased likelihood of death in children: A systematic review. J Child Health Care 2018; 22:147-158. [PMID: 29110529 DOI: 10.1177/1367493517732839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Improved identification of children with an increased likelihood of death can support appropriate provision of integrated palliative care. This systematic review aims to consider immobility and the associated likelihood of death in children with disabilities, living in high-income countries. Two reviewers independently searched MEDLINE, Embase, Cochrane Library, OpenGrey and Science Citation Index (1990-2016) for studies that reported hazard ratios (HRs) and relative risk for the likelihood of death related to impaired mobility. Nine papers were included. Three studies reported functioning using the Gross Motor Function Classification Scale (GMFCS) and the remaining studies reported measures of functioning unique to the study. The strongest single prognostic factor for the likelihood of death was 'lack of sitting ability at 24 months', HR 44.4 (confidence interval (CI) 6.1-320.8) followed by GMFCS V HR 16.3 (CI 5.6-47.2) and 11.4 (CI 3.76-35.57) and 'not able to cruise by 24 months', HR 14.4 (CI 3.5-59.2). Immobility is associated with an increased risk of dying over study periods, but different referent groups make clinical interpretation challenging. Overall, the quality of evidence is moderate. The findings suggest that immobility can support identification of children who may benefit from integrated palliative care.
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Affiliation(s)
- Sally Nissen
- 1 Department of Child and Family Health, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | | | - Karen Shaw
- 3 University of Birmingham, Birmingham, West Midlands, UK
| | - Cara Bailey
- 3 University of Birmingham, Birmingham, West Midlands, UK
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Akladious A, Azzam S, Hu Y, Feng P. Bmal1 knockdown suppresses wake and increases immobility without altering orexin A, corticotrophin-releasing hormone, or glutamate decarboxylase. CNS Neurosci Ther 2018; 24:549-563. [PMID: 29446232 DOI: 10.1111/cns.12815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 01/02/2018] [Accepted: 01/10/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the effect of Bmal1 knockdown (KD) on sleep, activity, immobility, hypothalamic levels of orexin, corticotrophin-releasing hormone (CRH), and GABAergic glutamate decarboxylase (GAD). METHODS We used Bmal1 siRNA, or control siRNA intracerebroventricular (ICV) injection to knock down Bmal1 in C57BL/6 mice. Sleep polysomnography, wheel-running activity, and tail suspension test were performed. Polysomnographic (PSG) recordings in both groups were preceded by ICV injection made during both the light phase and the dark phase. We also measured brain orexin A and CRH using an ELISA and measured GAD using immunoblotting. RESULTS Compared with control group, Bmal1 KD group had reduced wheel activity and increased immobility. Compared with control, the Bmal1 KD group had reduced wheel activity and increased immobility. During the first 24 hours after treatment, we observed that control siRNA induced a much greater increase in sleep during the dark phase, which was associated with lower orexin levels. However, beginning 24 hours after treatment, we observed an increase in sleep and a decrease in time spent awake during the dark phase in the Bmal1 KD group. These changes were not associated with changes in brain levels of orexin A, CRH, or GAD. CONCLUSION Bmal1 KD led to reduced activity, increased immobility, and dramatic reduction in time spent awake as well as an increase in sleep during the dark phase. Early after injection, there was a slight change in sleep but brain levels of orexin, CRH, and GAD remain unchanged. Control siRNA also affected sleep associated with changes in orexin levels.
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Affiliation(s)
- Afaf Akladious
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Sausan Azzam
- Division of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Yufen Hu
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.,Division of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Pingfu Feng
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.,Division of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University, Cleveland, OH, USA
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Källman U, Bergstrand S, Ek AC, Engström M, Lindgren M. Blood flow responses over sacrum in nursing home residents during one hour bed rest. Microcirculation 2018; 23:530-539. [PMID: 27534925 PMCID: PMC5096247 DOI: 10.1111/micc.12303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 08/11/2016] [Indexed: 11/29/2022]
Abstract
Objectives To describe individual BF responses in a nursing home resident population for one‐hour periods of bed rest. Methods BF was measured for one hour over the sacrum in 0° supine position and 30° supine tilt position in 25 individuals aged 65 y or older while lying on a pressure‐redistributing mattress. Measurements were made at three tissue depths (1, 2, and 10 mm) using the noninvasive optical techniques, LDF and PPG. Results Eleven participants had a PIV response at 1 mm depth in both positions and seven participants had a lack of this response at this depth and positions. The BF response at 1 mm depth appeared immediately and remained over, or below, baseline for the entire 60 min of loading in both positions. These BF patterns were also seen in deeper tissue layers. Conclusions The cutaneous BF response among the nursing home residents was distinct, appeared early, and remained during the one hour of loading.
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Affiliation(s)
- Ulrika Källman
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden. .,Department of Research, Södra Älvsborgs Sjukhus, Borås, Sweden.
| | - Sara Bergstrand
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
| | - Anna-Christina Ek
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
| | - Maria Engström
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
| | - Margareta Lindgren
- Department of Medical and Health Sciences, Division of Nursing Linköping University, Linköping, Sweden
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45
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Bilska A, Francikowski J, Wyglenda A, Masłowski A, Kaszyca N, Depa Ł. Aphids Playing Possum - Defensive or Mutualistic Response? J Insect Behav 2018; 31:42-53. [PMID: 29527095 PMCID: PMC5834575 DOI: 10.1007/s10905-018-9662-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 12/21/2017] [Accepted: 01/11/2018] [Indexed: 06/02/2023]
Abstract
Paper presents the phenomenon of thanatosis or death-feigning in selected aphids species. This specific reaction was predominantly analysed on the example of aphid subfamily Lachninae. Individuals of this group were used in experiments, during which a thanatotic response was induced with various results. The response differed from prolonged thanatosis, lasting for several minutes (Eulachnus rileyi), through shrinking behaviour (e. g. in Stomaphis graffii) to non-responsive species such as Cinara (Schizolachnus) pineti. The large interspecies variation of observed responses can be linked to other defensive mechanisms existing in the studied species, as well as to their mutualistic relationship with ants. The behaviour of shrinking is hypothesized to be the mutualistic response, developed from thanatosis, and being adapted to transportation by ant workers.
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Affiliation(s)
- Aleksandra Bilska
- Department of Zoology, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
- Students’ Scientific Association of Zoologists “Fauantycy”, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
| | - Jacek Francikowski
- Department of Animal Physiology and Ecotoxicology, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
| | - Aleksandra Wyglenda
- Department of Zoology, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
- Students’ Scientific Association of Zoologists “Fauantycy”, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
| | - Adrian Masłowski
- Department of Zoology, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
- Students’ Scientific Association of Zoologists “Fauantycy”, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
| | - Natalia Kaszyca
- Department of Zoology, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
- Students’ Scientific Association of Zoologists “Fauantycy”, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
| | - Łukasz Depa
- Department of Zoology, Faculty of Biology and Environmental Protection, University of Silesia, Bankowa 9, 40-007 Katowice, Poland
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Kurokami T, Takasawa R, Takeda S, Kurobe M, Takasawa K, Nishioka M, Shimohira M. Venous thromboembolism in two adolescents with Down syndrome. Turk J Pediatr 2018; 60:429-432. [PMID: 30859769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Kurokami T, Takasawa R, Takeda S, Kurobe M, Takasawa K, Nishioka M, Shimohira M. Venous thromboembolism in two adolescents with Down syndrome. Turk J Pediatr 2018; 60: 429-432. Although venous thromboembolic events are relatively rare in children, they are an increasingly recognized clinical entity in pediatric tertiary care hospitals. Although vascular disorders are prevalent with Down syndrome, it remains unclear whether Down syndrome patients are at higher risk for venous thromboembolic events. We report two adolescent cases with Down syndrome who unexpectedly developed venous thromboembolism in a general care unit. Our cases had a few risk factors; laparoscopic radical surgery for Hirschsprung's disease with central venous catheterisation in Case 1, and bacterial hepatic abscess in Case 2. Despite preventive heparinization with catheterisation and minor surgery in Case 1 and non-sepsis in Case 2, bed rest for only a few days triggered sudden onset of deep vein thrombosis in lower limbs with pulmonary thromboembolism in both cases. We speculate that the characteristics of Down syndrome, including physical and behavioural problems, might cause venous thromboembolic events. Thus, we should pay more attention to the relationship specifically between venous thromboembolism and Down syndrome, especially in adolescents, and increase prevention, early detection and treatment efforts.
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Affiliation(s)
| | - Reiko Takasawa
- Departments of Pediatrics, Kawaguchi Municipal Medical Center, Japan
| | - Sayaka Takeda
- Departments of Pediatrics, Kawaguchi Municipal Medical Center, Japan
| | - Masashi Kurobe
- Departments of Pediatric Surgery and Kawaguchi Municipal Medical Center, Japan
| | | | - Masato Nishioka
- Departments of Pediatrics, Kawaguchi Municipal Medical Center, Japan
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47
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Ramic E, Selmanovic S, Alibasic E, Dzananovic D, Dzafic F, Ramic I. The Frequency of Multifactorial Syndromes in Geriatrics of Tuzla Canton Population. Mater Sociomed 2017; 29:268-271. [PMID: 29284997 PMCID: PMC5723185 DOI: 10.5455/msm.2017.29.268-271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: There are four main multifactorial syndromes in geriatrics the so-called “4N”, which specifically occur at elderly patients. Listed syndromes often occur related, and they can be the cause and the result of many other syndromes at geriatric patients. Objective: determine the difference in the assessment of the level of immobility, instability, dependence, urinary incontinence (“4N”) in elderly groups. Materials and methods: The research included total 200 elderly respondents experimental group made of elderly persons (>65 years) living alone. Control group included elderly persons living in a family environment. Universal geriatric questionnaire was made for this research. For fast orientation the redone questionnaire was used for our conditions: examination in clinics for usual elderly problems “Short list for examination”. For the assessment of the mental abilities reduction at elderly we used “Short portable mental status questionnaire” (SPMSQ). Results: In total sample the research included 200 elderly respondents, 45% in experimental group and 55% in control group. The average age (±SD) was 75,4±6,2 years in the experimental group, while in the control group the average age was 74,9±5,6 years. We notice nearly equal distribution of falling risk according to groups (50%, 47%). In total sample there were 62% mobile, 22,5% limited mobility, and 4% immobile. Dependence frequency was more represented at examination group respondents (p=0,002). Dependence chances (OR) were 2,05 times larger (95 %CI=1,12-3,75) in examination group than in control group respondents. Frequency of urinary incontinence problem is significantly represented at all our respondents (42,2% v.s. 35%). Conclusion: Permanent gerontology and geriatrics training is needed both family medicine doctors and other experts in the field of elderly health protection and preventive health measures, pharmacotherapy, palliative care, especially about four main geriatrics syndromes at elderly.
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Affiliation(s)
- Enisa Ramic
- Primary Health Care Center and Polyclinics Dr Mustafa Sehović, Tuzla, Bosnia and Herzegovina
| | - Senada Selmanovic
- Primary Health Care Center and Polyclinics Dr Mustafa Sehović, Tuzla, Bosnia and Herzegovina
| | - Esad Alibasic
- Primary Health Care Center Kalesija, Bosnia and Herzegovina
| | - Dzevad Dzananovic
- Primary Health Care Center and Polyclinics Dr Mustafa Sehović, Tuzla, Bosnia and Herzegovina
| | - Fejzo Dzafic
- University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Irma Ramic
- Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina
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48
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Hurst K, Badgley C, Ellsworth T, Bell S, Friend L, Prince B, Welch J, Cowan Z, Williamson R, Lyon C, Anderson B, Poole B, Christensen M, McNeil M, Call J, Edwards JG. A putative lysophosphatidylinositol receptor GPR55 modulates hippocampal synaptic plasticity. Hippocampus 2017; 27:985-998. [PMID: 28653801 DOI: 10.1002/hipo.22747] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/22/2017] [Accepted: 05/26/2017] [Indexed: 11/08/2022]
Abstract
GPR55, an orphan G-protein coupled receptor, is activated by lysophosphatidylinositol (LPI) and the endocannabinoid anandamide, as well as by other compounds including THC. LPI is a potent endogenous ligand of GPR55 and neither GPR55 nor LPIs' functions in the brain are well understood. While endocannabinoids are well known to modulate brain synaptic plasticity, the potential role LPI could have on brain plasticity has never been demonstrated. Therefore, we examined not only GPR55 expression, but also the role its endogenous ligand could play in long-term potentiation, a common form of synaptic plasticity. Using quantitative RT-PCR, electrophysiology, and behavioral assays, we examined hippocampal GPR55 expression and function. qRT-PCR results indicate that GPR55 is expressed in hippocampi of both rats and mice. Immunohistochemistry and single cell PCR demonstrates GPR55 protein in pyramidal cells of CA1 and CA3 layers in the hippocampus. Application of the GPR55 endogenous agonist LPI to hippocampal slices of GPR55+/+ mice significantly enhanced CA1 LTP. This effect was absent in GPR55-/- mice, and blocked by the GPR55 antagonist CID 16020046. We also examined paired-pulse ratios of GPR55-/- and GPR55+/+ mice with or without LPI and noted significant enhancement in paired-pulse ratios by LPI in GPR55+/+ mice. Behaviorally, GPR55-/- and GPR55+/+ mice did not differ in memory tasks including novel object recognition, radial arm maze, or Morris water maze. However, performance on radial arm maze and elevated plus maze task suggests GPR55-/- mice have a higher frequency of immobile behavior. This is the first demonstration of LPI involvement in hippocampal synaptic plasticity.
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Affiliation(s)
- Katrina Hurst
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Corinne Badgley
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Tanner Ellsworth
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Spencer Bell
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602.,Neuroscience Center, Brigham Young University, Provo, Utah, 84602
| | - Lindsey Friend
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602.,Neuroscience Center, Brigham Young University, Provo, Utah, 84602
| | - Brad Prince
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Jacob Welch
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Zack Cowan
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Ryan Williamson
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602.,Neuroscience Center, Brigham Young University, Provo, Utah, 84602
| | - Chris Lyon
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Brandon Anderson
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Brian Poole
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602.,Neuroscience Center, Brigham Young University, Provo, Utah, 84602
| | - Michael Christensen
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602.,Neuroscience Center, Brigham Young University, Provo, Utah, 84602
| | - Michael McNeil
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Jarrod Call
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602
| | - Jeffrey G Edwards
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah, 84602.,Neuroscience Center, Brigham Young University, Provo, Utah, 84602
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Prudius D, Weber P, Matějovská Kubešová H, Meluzínová H, Polcarová V, Bieláková K. Pulmonary embolism in the hospitalized patients 65+ in relation to presence of diabetes in 2007-2015. Adv Gerontol 2017; 30:703-708. [PMID: 29322737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED The aim was to compare an occurrence of acute PE in hospitalized patients 65+ years old with diabetes mellitus (DM) with those without any DM. It was a retrospective analysis of data collected in documentation of patients who were hospitalized at the geriatric department in the years 2007-2015. In this period we had 11 947 patients of an average age of 79,9±8,5 years (min - 65, max - 103 years). Out of this number there were 4 069 diabetics. Acute PE was found in 344 patients of an average age 80,3±7,4 years. 121 of them died (35,3%) and 223 survived (64,7%). From total patients 88 were diabetics with PE. Mortality on PE did not influence the presence of DM. She was the same in both groups of patients (p=NS) - with and without DM. RESULTS Prevalence PE in the hospitalized 65+ years old was 2,9%. Mortality of PE among all the hospitalized 65+ was 1,0%. Higher prevalence of PE was found in non-diabetics - 3,2%, as compared to the diabetics - 2,3% (p<0,025). The average age of patients with diabetes both with and without PE was lower as compared to the non-diabetics (p<0,01). Among risk factors we found significantly more frequently obesity in the diabetics as compared to the non-diabetics both surviving (p<0,001) and those who died (p<0,05). The most important risk factor of PE was in all the patient's immobility. One risk factor appeared in the set of survivors more frequently in the non-diabetics as compared to the diabetics (p<0,05). Simultaneous occurrence of three risk factors appeared more frequently in the surviving diabetics (p<0,001) as compared to the non-diabetics. Although overall presence of risk factors was higher in the diabetics, PE prevalence in the DM patients was lower as compared to the non-diabetics. The immobility in general was the most important risk factor for PE occurrence, in the diabetics then also obesity.
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Affiliation(s)
- D Prudius
- Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
| | - P Weber
- Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
| | - H Matějovská Kubešová
- Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
| | - H Meluzínová
- Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
| | - V Polcarová
- Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
| | - K Bieláková
- Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
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Braithwaite I, Healy B, Cameron L, Weatherall M, Beasley R. Venous thromboembolism risk associated with protracted work- and computer-related seated immobility: A case-control study. JRSM Open 2016; 7:2054270416632670. [PMID: 27540486 PMCID: PMC4973402 DOI: 10.1177/2054270416632670] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine the association between venous thromboembolism and prolonged work- and computer-related seated immobility. DESIGN A case-control study. PARTICIPANTS AND SETTING Cases were 200 patients attending venous thromboembolism clinics with a history of deep vein thrombosis and/or pulmonary embolism in the past six months, and controls were 200 patients treated in fracture clinic for an upper limb injury in the past six months. MAIN OUTCOME MEASURES Logistic regression was used to estimate the association between venous thromboembolism and prolonged work- and computer-related seated immobility in the 28 days before the index event. Prolonged work- and computer-related seated immobility was defined firstly as a categorical variable with at least 10 h seated in a 24-h period, including at least 2 h without getting up; and secondly as the actual time spent seated in a 24-h period. RESULTS Prolonged work- and computer-related seated immobility (categorical variable) was present in 36 (18%) cases and 31 (15.5%) controls. In multivariate analysis, there was no significant association between prolonged seated immobility and venous thromboembolism, odds ratio 1.18 (95% CI 0.56 to 2.48), P = 0.67. For the mean and maximum number of hours seated in a 24-h period, the odds ratios for the association per additional hour seated with venous thromboembolism were 1.08 (95% CI 1.01 to 1.6), P = 0.02 and 1.04 (95% CI 0.99 to 1.09), P = 0.08, respectively. CONCLUSION This study found a weak association between venous thromboembolism and prolonged work- and computer-related seated immobility, with increasing mean hours seated associated with a higher risk of venous thromboembolism.
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Affiliation(s)
- Irene Braithwaite
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
- Capital and Coast District Health Board, Wellington 6021, New Zealand
| | - Bridget Healy
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
| | - Laird Cameron
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
- Capital and Coast District Health Board, Wellington 6021, New Zealand
| | | | - Richard Beasley
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
- Capital and Coast District Health Board, Wellington 6021, New Zealand
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