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Conservative Interventions for mobile Pes Planus in Adults: a systematic review
Get PDFBackground. Adult pes planus (flat foot) is a common problem encountered by many health care professionals. Despite the perception that flat foot can cause pain and impair function, and the availability and widespread use of various treatments, there is no consensus on the optimal treatment strategy. Aim. To assess the effectiveness of conservative (non-surgical) interventions for pes planus in adults. Method. A systematic search of the literature was undertaken. This included: the Cochrane Central Register of Controlled Trials; the CMSG Specialized Trials Register; an electronic search was conducted using MEDLINE (1960 to June 2012), EMBASE (1980 to June 2012), and CINAHL (1982 - June 2012). Specialised journals, trial reference lists and review articles were hand searched.
Selection criteria: Randomised or quasi-randomised trials of treatment interventions for pes planus in adults. Trials that included specific pathologies such as plantar heel pain, metatarsal stress fractures, posterior-tibial tendon dysfunction, ankle fractures, rheumatoid foot pathologies, neuromuscular conditions and diabetic foot complications were excluded. Data collection and analysis: Two authors independently screened the search results to identify those meeting the inclusion criteria and quality assessed those included using a checklist based on the Cochrane Collaboration Assessment of Risk of Bias tool. This tool focused on risk of selection, performance, detection, attrition and reporting bias. Results. Four trials, involving 140 subjects, met the inclusion criteria for the review. All four were judged to be at high risk of bias in at least one area, and were also at unclear risk of bias in at least one other area. All scored highly in relation to attrition bias, due to the short follow up times and experimental designs used. Data was not pooled due to the high level of heterogeneity identified in the interventions assessed, participants selected and outcomes measured. The results of one study suggest that after four weeks of use orthoses may result in a significant improvement in medio lateral sway, and may result in improved, although non-significant, general foot-related quality of life (Rome 2004). One study (Redmond 2009) suggests that their effect on plantar pressure distribution in the foot may not be dependent on whether they are custom or prefabricated devices. Although this study identified significant changes in some plantar pressure variables with both custom and prefabricated devices, another (Esterman 2005) failed to find any significant effect of ¾ length prefabricated orthoses on pain, injury incidence, foot health or quality of life in a group of air force recruits. The fourth study (Jung 2009) suggests that exercising the intrinsic foot muscles may enhance the effect of orthoses. Despite these findings, since each study incurred risk of bias in at least one area no conclusions can be drawn
Pip and Pop: When auditory alarms facilitate visual change detection in dynamic settings
Get PDFDynamic and complex command and control situations often require the timely recognition of changes in the environment in order to detect potentially malicious actions. Change detection can be challenging within a continually evolving scene, and particularly under multitasking conditions whereby attention is necessarily divided between several subtasks. On-screen tools can assist with detection (e.g., providing a visual record of changes, ensuring that none are overlooked), however, in a high workload environment, this may result in information overload to the detriment of the primary task. One alternative is to exploit the auditory modality as a means to support visual change detection. In the current study, we use a naval air-warfare simulation, and introduce an auditory alarm to coincide with critical visual changes (in aircraft speed/direction) on the radar. We found that participants detected a greater percentage of visual changes and were significantly quicker to detect these changes when they were accompanied by an auditory alarm than when they were not. Furthermore, participants reported that mental demand was lower in the auditory alarm condition, and this was reflected in reduced classification omissions on the primary task. Results are discussed in relation to Wickens’ multiple resource theory of attention and indicate the potential for using the auditory modality to facilitate visual change detection
An investigation into the effects of in vitro dilution with different colloid resuscitation fluids on clot microstructure formation
Get PDFBACKGROUND: Balancing the beneficial effects of resuscitation fluids against their detrimental effect on hemostasis is an important clinical issue. We aim to compare the in vitro effects of 3 different colloid resuscitation fluids (4.5% albumin, hydroxyethyl starch [Voluven 6%], and gelatin [Geloplasma]) on clot microstructure formation using a novel viscoelastic technique, the gel point. This novel hemorheologic technique measures the biophysical properties of the clot and provides an assessment of clot microstructure from its viscoelastic properties. Importantly, in contrast to many assays in routine clinical use, the measurement is performed using unadulterated whole blood in a near-patient setting and provides rapid assessment of coagulation. We hypothesized that different colloids will have a lesser or greater detrimental effect on clot microstructure formation when compared against each other.
METHODS: Healthy volunteers were recruited into the study (n = 104), and a 20-mL sample of whole blood was obtained. Each volunteer was assigned to 1 of the 3 fluids, and the sample was diluted to 1 of 5 different dilutions (baseline, 10%, 20%, 40%, and 60%). The blood was tested using the gel point technique, which measures clot mechanical strength and quantifies clot microstructure (d f) at the incipient stages of fibrin formation.
RESULTS: d f and clot mechanical strength decrease with progressive dilution for all 3 fluids. A significant reduction in d f from baseline was recorded at dilutions of 20% for albumin (P < .0001), 40% for starch (P < .0001), and 60% for gelatin (P < .0001). We also observed significant differences, in terms of d f, when comparing the different types of colloid (P < .0001). We found that albumin dilution produced the largest changes in clot microstructure, providing the lowest values of d f (= 1.41 ± 0.061 at 60% dilution) compared with starch (1.52 ± 0.081) and gelatin (1.58 ± 0.063).
CONCLUSIONS: We show that dilution with all 3 fluids has a significant effect on coagulation at even relatively low dilution volumes (20% and 40%). Furthermore, we quantify, using a novel viscoelastic technique, how the physiochemical properties of the 3 colloids exert individual changes on clot microstructure
Time-temperature profiling of UK consumers’ domestic refrigerators
No full textIncreased consumer demand for convenience and ready-to-eat (RTE) food, along with changes to consumer food purchase and storage practices have resulted in an increased reliance on refrigeration to maximize food safety. Previous research suggests that many domestic refrigerators operate at temperatures exceeding recommendations, however several studies are determined by means of one temperature data point, which, given temperature fluctuation, may not be a true indicator of actual continual operating temperature. Data detailing actual operating temperature and the impact of consumer practice on temperature are limited. This study has collated the time-temperature profiles of domestic refrigerators in consumer kitchens (n=43) over 6.5 days with concurrent self-report refrigerator usage. Overall, findings established a significant difference (p<0.05) between one-off temperature and mean operating temperature. No refrigerator operated at ≤5.0°C for the entire duration of the study. Mean temperatures exceeding 5.0°C were recorded in the majority (91%) of refrigerators. No significant associations or differences were determined between temperature profiles and demographics including household size and refrigerator characteristics (age, type, loading and location). A positive correlation (p<0.05) between room temperature and refrigerator temperature was determined. Reported door opening frequency correlated with temperature fluctuation (p<0.05). Thermometer usage was determined to be infrequent. Cumulatively, research findings have established that the majority of domestic refrigerators in consumer homes operated at potentially unsafe temperatures influenced by consumer usage. Findings from this study may be utilized to inform the development of shelf-life testing based on realistic domestic storage conditions. Furthermore, data can inform development of future educational interventions to increase safe domestic refrigeration practices
LAUGH: Designing to enhance positive emotion for people living with dementia
Get PDFDementia comprises a number of degenerative neurological diseases. It is a complex condition and each person’s experience and symptoms are different. There is a growing awareness of the need for well-designed products and services to assist with dementia care and to enhance wellbeing. This paper presents research investigating the design of playful objects for people with late stage dementia. The investigation described is a preliminary stage in the LAUGH (Ludic Artefacts Using Gesture and Haptics) project; an AHRC funded international, interdisciplinary design research project. People living with dementia, informal and professional carers, health professionals, art therapists, charity representatives, arts practitioners and designers are informing the research through a series of expert group participatory workshops and case study interviews. Observation, discussion, video, photography and investigation. Findings presented in this paper focus on the importance of emotional memory and emotional expression in the care of people with late stage dementia; the value of sensory triggers and props to stimulate emotional remembering; and the importance of designing to promote high quality social connections
High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation
Get PDFIntroduction
Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the ‘modern’ patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes.
Methods and analysis
This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes.
Ethics and dissemination
The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands—Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR
Social representation of "music" in young adults: a cross-cultural study
Get PDFObjective: This study was aimed to explore perceptions of and reactions to music in young adults (18–25 years) using the theory of social representations (TSR). Design: The study used a cross-sectional survey design and included participants from India, Iran, Portugal, USA and UK. Data were analysed using various qualitative and quantitative methods. Study sample: The study sample included 534 young adults. Results: The Chi-square analysis showed significant differences between the countries regarding the informants’ perception of music. The most positive connotations about music were found in the responses obtained from Iranian participants (82.2%), followed by Portuguese participants (80.6%), while the most negative connotations about music were found in the responses obtained from Indian participants (18.2%), followed by Iranian participants (7.3%). The participants’ responses fell into 19 main categories based on their meaning; however, not all categories were found in all five countries. The co-occurrence analysis results generally indicate that the category “positive emotions or actions” was the most frequent category occurring in all five countries. Conclusions: The results indicate that music is generally considered to bring positive emotions for people within these societies, although a small percentage of responses indicate some negative consequences of music
Exploring lived heat, "temperature work," and embodiment: Novel auto/ethnographic insights from physical cultures
Get PDFDrawing on sociological and anthropological theorisations of the senses and "sensory work," the purpose of this article is to investigate via phenomenology-based auto/ethnography, and to generate novel insights into the under researched sense of thermoception, as the lived sense of temperature. Based on four long-term, in-depth auto/ethnographic research projects, we examine whether thermoception can be conceptualized as a distinct sense or is more appropriately categorized as a specific modality of touch. Empirically and analytically to highlight the salience of thermoception in everyday life, we draw on findings from four auto/ethnographic projects conducted by the authors as long-standing insider members of their various physical-cultural lifeworlds. the foci of the research projects span the physical cultures of distance running, mixed martial arts, traditionalist Chinese martial arts, and boxing. While situated within distinctive physical-cultural frameworks, nevertheless, the commonalities in the thermoceptive elements of our respective experiences as practitioners were striking, and thermoception emerged as highly salient across all four lifeworlds. Our analysis explores the key auto/ethnographic findings, entering on four specific areas: elemental touch, heat of the action, standing still, and tuning in. Emerging from all four studies were key findings relating to the valorization of sweat, and the importance of "temperature work" involving thermoceptive somatic learning, and physical-culturally specific bodily ways of knowing and sense-making. These in turn shape how heat and cold are actually "felt" and experienced in the mind-body.
Keywords: auto/ethnography; senses; thermoception; temperature work; physical culture
Effects of gluteal kinesio-taping on performance with respect to fatigue in rugby players
Get PDFKinesio-tape® has been suggested to increase blood circulation and lymph flow and might influence the muscle's ability to maintain strength during fatigue. Therefore, the aim of this study was to investigate the influence of gluteal Kinesio-tape® on lower limb muscle strength in non-fatigued and fatigued conditions. A total of 10 male rugby union players performed 20-m sprint and vertical jump tests before and after a rugby-specific fatigue protocol. The 20-m sprint time was collected using light gates (SMARTSPEED). A 9-camera motion analysis system (VICON, 100 Hz) and a force plate (Kistler, 1000 Hz) measured the kinematics and kinetics during a counter movement jump and drop-jump. The effect of tape and fatigue on jump height, maximal vertical ground reaction force, reactivity strength index as well as lower limb joint work were analysed via a two-way analysis of variance. The fatigue protocol resulted in significantly decreased performance of sprint time, jump heights and alterations in joint work. No statistical differences were found between the taped and un-taped conditions in non-fatigued and fatigued situation as well as in the interaction with fatigue. Therefore, taping the gluteal muscle does not influence the leg explosive strength after fatiguing in healthy rugby players
The cross on rings performed by an Olympic champion
Get PDFThe cross is a key skill in Male Artistic Gymnastics rings routines. However, few researches were found about this skill. There is knowledge about the forces needed to perform the cross, or about muscles activation, separately. The aim of this paper was to accomplish a comprehensive research about the biomechanics of cross on rings, in order to obtain a descriptive model about this skill. Therefore, the currently Olympic champion on rings event volunteered in this research. He performed three crosses with the usual apparatus in his training gym. The measurement methods were combined: One digital video camera, one strain gauge in each cable and surface electromyography of nine right shoulder muscles were used. Statistical analyses
were performed by parametric and non parametric tests and descriptive statistics. Symmetry values were calculated for shoulder angles and cables of right and left side. Coefficient of variation of muscle activation and co contraction were verified. Within gymnast variability was calculated using biological coefficient of variation (BCV), discretely for kinematic measures. Low variability values of shoulder angles and cable forces were verified and low values of asymmetry as well. Muscle activation varied according to muscle function, while co-contraction values were different among trials. These results pointed out the
characteristics of the cross performed by an elite gymnast. Knowledge about the characteristics of cross can inform coaches, practitioners and clinicians how a successful skill should be presented