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Background: People with Parkinson's disease (PD) have a high fall rate and many falls are associated with turns. Despite this, there is minimal research on effects of rehabilitation on the quality of turns. Further, quantifying turns in the home may have broader implications since rehabilitation of turns would ideally improve turning in real world mobility.Methods: Sixty people with PD and a history of falls will be randomized to receive either a novel TURNing InTervention (TURN-IT) or no intervention (control group). The TURN-IT group will be seen for 6 weeks (18 visits) for an individualized, progressive program that is based on the specific constraints of turning in PD. Wearable sensors will be used to measure 7 days of mobility, including turns, before and after intervention or control period. In addition, blinded assessments of gait, mobility and turns will occur before and after intervention for both groups and falls will be monitored for twelve months post intervention with bimonthly email questionnaires.Discussion: This study has the potential to change how we rehabilitate and assess turning in people with PD and falls. There are several novel aspects to our study including a comprehensive turning-focused intervention that is tailored to the underlying constraints that impair turning in people with PD. Further, our outcome measure of turning quality during 7 days of daily life is novel and has implications for determining real-life changes after rehabilitation. The ultimate goal of this rehabilitation intervention is to improve how patients turn in daily life and to reduce falls.Trials Registration: This protocol is registered at clinicaltrials.gov; #NCT04897256; https://clinicaltrials.gov/ct2/show/NCT04897256?term=Horak&cond=Parkinson+Disease&draw=2&rank=4 . [ABSTRACT FROM AUTHOR]

This article introduces a new framework for therapists to develop an exercise program to delay mobility disability in people with Parkinson disease (PD). Mobility, or the ability to efficiently navigate and function in a variety of environments, requires balance, agility, and flexibility, all of which are affected by PD. This article summarizes recent research identifying how constraints on mobility specific to PD, such as rigidity, bradykinesia, freezing, poor sensory integration, inflexible program selection, and impaired cognitive processing, limit mobility in people with PD. Based on these constraints, a conceptual framework for exercises to maintain and improve mobility is presented. An example of a constraint-focused agility exercise program, incorporating movement principles from tai chi, kayaking, boxing, lunges, agility training, and Pilates exercises, is presented. This new constraint-focused agility exercise program is based on a strong scientific framework and includes progressive levels of sensorimotor, resistance, and coordination challenges that can be customized for each patient while maintaining fidelity. Principles for improving mobility presented here can be incorporated into an ongoing or long-term exercise program for people with PD. [ABSTRACT FROM AUTHOR]

Risk factors associated with war-zone events and circumstances are implicated in the health and adjustment of military veterans. We assessed a national stratified sample of community-residing veterans of the Gulf War (N = 357) using scales from the Deployment Risk and Resilience Inventory, along with an array of mental (posttraumatic stress disorder, depression, and anxiety), physical (symptom and condition indicators especially pertinent to Gulf War illnesses), and functional (both mental and physical dimensions) health outcomes. We found that perceived threat or fear of bodily harm in the war zone and self-reported or perceived exposures to environmental hazards may play a critical role in all measured aspects of health. Moreover, a synergistic effect of these two risk factors was observed in the prediction of mental health and mental health functional status. [ABSTRACT FROM AUTHOR]

Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse. [ABSTRACT FROM AUTHOR]

This article reports on the key findings of a 2-year study of faith-based responses to homelessness in Greater Seattle (the United States). Leveraging opportunities and negotiating constraints through experimentation, congregations, and faith-based non-profits, in different ways, are striving to blend local knowledge and professional knowledge, the adaptability of bottom-up civic engagement and the complexities of top-down programming to rethink homelessness interventions. After considering this picture of faith-based organizations (FBOs) as community problem solvers, we sketch three case studies of innovative initiatives: the Network Builders program of Catholic Community Services of Western Washington-King County, the interfaith and cross-sectoral campaign against family homelessness spearheaded by Associated Ministries of Tacoma-Pierce County, and the Para-Navigator partnership between Everett Gospel Mission and the municipal government of Snohomish County. [ABSTRACT FROM AUTHOR]

La década de los sesenta en Estados Unidos es, sin duda, la década de la democratización. En esa época se sitúa la serie Mad Men, la cual recrea el mundo de los publicistas y su estrecha relación con la televisión, medio que nos da una visión de hechos históricos y explica cómo ha cambiado la vida cotidiana, cómo era en el pasado y cómo es ahora. El presente artículo revisa dicha serie como reconstructora de memoria colectiva que cuestiona y propone nuevas significaciones sociales sobre el proceso demo¢ratizador que se vivió, en la década de los sesenta, en Estados Unidos. Mediante la metodología del análisis del discurso televisivo de esta serie, la autora comenta los cambios sociales y culturales que vive la sociedad norteamericana de esa época. De esta forma pone de manifiesto el papel del hombre y de la mujer, la transformación de la familia, los movimientos en defensa de los derechos civiles, la contracultura, los asesinatos del presidente Kennedy y de Martin Luther King, la guerra de Vietnam, etcétera. Así, a través de la descripción de esta serie, que muestra hechos importantes en la historia de Estados Unidos, se construye-reconstruye parte de la memoria colectiva de ese país. [ABSTRACT FROM AUTHOR]

Issue Addressed: Food availability affects eating habits, and in the Australian context, refers to the numbers and locations of food retail and food service outlets and the types and range of foods in those outlets. The aim of this study was to assess the community and consumer food environment in three small rural towns in New South Wales, Australia.Methods: Geographical analyses were used to measure the diversity, variety and locations of food outlets (community food environment); and checklists were used to assess the availability of selected indicator foods within food outlets (consumer food environment).Results: Supermarkets provided access to the full range of healthy indicator foods, with convenience stores selling a more limited set of healthy food items. There were high numbers of take-away food outlets in each town that had no, or a limited number of, healthy food items. Energy-dense, nutrient-poor foods such as soft drinks and potato crisps were readily available across all food retail outlets in all towns.Conclusion: This study illustrates a valid, reliable and practical way of systematically describing food availability at a local level. The findings emphasise the ubiquity of energy-dense, nutrient-poor foods, and suggest that interventions to promote the availability of healthier food items in take-away food outlets are required. Further research is required to assess other factors which may affect residents' food access, such as cost and transport. [ABSTRACT FROM AUTHOR]

It has become clear that firm performance has important implications for employees and organizations as confirmed by past researchers. This study examines human resource practices and the impact of incentives on manufacturing companies in the Malaysia context. Three types of human resource practices namely, performance appraisal, training, and information technology have been chosen as the focus of this research with the presence of incentives as moderator on organizational performance. This is imperative in order to ensure the successful management of employees and also to improve productivity and achievements of an organization. The research uses a sample of eighty-five firms in Sarawak, Malaysia, voluntarily participated in this study. The results have indicated that the two components of human resource (HR) practices namely, training and information technology have direct impact on organizational performance. It was found that incentive is positively related to organizational performance but did not moderate the relationship between both HR practices and organizational performance. Implications of the findings, potential limitations of the study, and directions for future research are suggested. [ABSTRACT FROM AUTHOR]

The obesity epidemic appears set to worsen the morbidity and mortality from leading causes of death in Australia - ischaemic heart disease, stroke and obesity-related cancers. The aim of this study was to compare hospital separations, deaths and direct health costs for middle-aged adults (45 to 54 years) in 2004/05 with those attaining age 45 to 54 years in 2024/25 who were born into an obesogenic environment. Using data from National Health Surveys, prevalence of obesity in 2004/05 was calculated for those born in 1950/51-59/60 and four scenarios were considered to project rates in 2024/25 for those born in 1970/71-79/80: an age-cohort model; a linear trend model; a steady state where rates increase to equal those of the older birth cohort at the same age; and a best case where rates remain at 2004/05 levels. Population attributable fractions were calculated by gender and disease using relative risks of disease from the literature, and applied to hospital separations, deaths, and direct health system costs data to estimate the proportion of each attributable to obesity. In 2024/25 the projected number of hospitalizations of 45 to 54 year olds due to the diseases of interest could be more than halved, over 200 lives rescued and $51.5 million (in 2004/05 dollars) saved if further gains in obesity in the younger birth cohort are halted. Instead, if the worst case scenario is realized there will be a more than doubling in costs (in 2004/05 dollars) compared with those born in 1950/51-59/60. [ABSTRACT FROM AUTHOR]

In response to identified deficits in the provision of health care to female patients, we sought to improve healthcare workers' gender awareness- conceptualized as gender-role ideology, sensitivity, and knowledge related to female patients-through the application of a brief computerized educational intervention. This study, conducted in the Veterans Affairs (VA) health-care setting, involved a pretest-posttest equivalent control group design. We evaluated hypotheses using random coefficients regression, a technique that offers a number of advantages relative to repeated-measures ANOVA. Findings revealed significant improvements in sensitivity and knowledge for participants in the treatment condition compared to the control condition. With several exceptions, the intervention was similarly effective across employee groups. Copyright © 2008 SAGE Publications Ltd. [ABSTRACT FROM AUTHOR]

The thrust of a recently published transportation vision for Toronto is focused largely on reducing automobile dependence via a number of interacting strategies, including the wide application of transit priority policies to improve transit competitiveness. This paper reports on quantifying the impacts of several transit priority schemes, with the streetcar operation along King Street in the heart of Toronto as a case study. Four scenarios were modelled in a micro simulation framework. They include the status quo (involving unconditional transit signal priority, already in operation), turning off existing transit signal priority, prohibiting all left turns, and finally prohibiting traffic from King Street. To quantify the impacts of any of the above scenarios, a set of common measures of effectiveness was used, including transit travel time and speed, effective headway, service frequency and person throughput, bunching, fleet size implications, and overall traffic and transit average speeds. The results show the relative merits of the four scenarios and two strategies for improving streetcar service along the King route are recommended. The first is to prohibit all left turns along the route, while the second, admittedly more aggressive, is to potentially transform the arterial into a transit mall accessible only to streetcars. [ABSTRACT FROM AUTHOR]

FACING INDUSTRIAL unrest in each of its Canadian petroleum refineries, the Imperial Oil Company embarked on a wide-ranging industrial-relations initiative in 1919. Patterned after Mackenzie King's "Rockefeller Plan," the logic was clear: joint worker-management councils would alleviate shop-floor discontent; a package of welfare benefits would reduce absenteeism and turnover; and a share-purchase plan would enhance worker loyalty to the Company. Where similar attempts at corporate welfarism in Canada generally failed, Imperial Oil enjoyed a union-free status until 1946, and freedom from work stoppages until the early 1950s. What made it unique in this regard was its willingness and capacity to buy labour harmony; and in an era hostile to organized labour, its workers succeeded in extracting important monetary concessions as the price of their loyalty. Imperial Oil thus offers a cogent example of the conditions necessary for King's variant of welfare capitalism to flourish. [ABSTRACT FROM AUTHOR]

Issue Addressed: Many children consume excessive amounts of energy-dense, nutrient-poor (EDNP) or 'extra' foods and low intakes of fruit and vegetables. The aim of this study was to examine the associations between EDNP foods and ascertain whether certain EDNP foods and beverages are more likely to be eaten in association with other EDNP foods.Methods: A cross-sectional representative population survey of children in preschool (n=764), and of school students in Years K, 2 and 4 (n=1,560) and in Years 6, 8 and 10 (n=1,685) residing in the Hunter New England region of New South Wales, Australia. Dietary data were collected using a short food frequency questionnaire. Multivariate logistic regression models examined the association between EDNP foods and fruit and vegetable intake. Data were stratified by sex and age cohort.Results: More frequent consumption of some EDNP food types was significantly associated with more frequent consumption of other EDNP foods. Fast food and soft drinks consumption were associated with each other as well as with fried potato and salty snacks; and with lower intakes of fruit and vegetables in some but not all age groups.Conclusion: The positive associations found between EDNP foods point towards the existence of a high-risk group of children who frequently consume a variety of EDNP foods and drinks. [ABSTRACT FROM AUTHOR]

Issue Addressed: Organised sport provides an important setting for health promotion. Peak sporting organisations have a role in assisting and overseeing sports clubs, including providing funding opportunities. As such, sponsorship of these organisations may influence the funding of community sport. This study aimed to describe the nature and scope of peak sporting organisations' sponsorship, and particularly food and beverage company sponsors.Methods: An analysis of national and state sporting organisations'websites for the nine most popular sports for children and from four Australian states and territories was conducted using a structured survey tool. Information collected included the number and type of sponsors and sponsorship policies.The nature of food and beverage sponsors was defined as more healthy or less healthy using criteria from a Delphi survey.Results: 443 sponsors were identified across 55 websites. Overall, 9% of sponsors were food companies and 3% were alcohol manufacturers. The majority of food companies (63%) and alcohol manufacturers (100%) did not meet criteria as healthy sponsors.Conclusions: Sponsorship of peak sporting organisations is widespread and consists of a relatively high proportion of alcohol manufacturers and food companies, some of which produce products considered to be unhealthy.This sponsorship may influence community sport through sponsored sporting programs or by indicating sponsors' acceptability. [ABSTRACT FROM AUTHOR]

To evaluate the impact of posttraumatic stress disorder (PTSD) on health-related functioning, we assessed 800 U.S. Army soldiers before and after 1-year military deployments to Iraq. As part of the Neurocognition Deployment Health Study procedures, each soldier completed at both time points self-report indexes of PTSD symptom severity, health behaviors (smoking, alcohol use), and somatic health-related functioning. Participants also completed a health-symptom checklist at the postdeployment assessment. Structural equation modeling revealed that postdeployment PTSD severity was associated with change in somatic health-related functioning, with postdeployment health symptoms as an intermediary variable. These relationships were independent of health risk behaviors, which had little association with somatic symptoms or PTSD. Our findings highlight the functional impact of PTSD, which extends beyond psychological symptoms to health-related daily functioning. [ABSTRACT FROM AUTHOR]

This study aimed to provide preliminary evidence for, and explore potential antecedents and correlates of, a phenomenon observed in aging combat veterans termed late-onset stress symptomatology (LOSS). LOSS is a hypothesized phenomenon among older veterans who (a) experienced highly stressful combat events in early adulthood; (b) functioned successfully throughout their lives, with no chronic stress-related disorders; but (c) begin to register increased combat-related thoughts, feelings, reminiscences, memories, or symptoms commensurate with the changes and challenges of aging, sometimes decades after their combat experiences. Using a qualitative focus group methodology with 47 World War II, Korean Conflict, and Vietnam War veterans, the authors obtained preliminary evidence for the presence of LOSS as defined, identified some of its features, revealed some normative late-life stressors that may precipitate LOSS, and uncovered potential intrapersonal risk and resilience factors for LOSS. The authors present illustrative quotations from the group discussions and discuss the implications and future directions of this research. [ABSTRACT FROM AUTHOR]

In response to the growing number of women within the Veterans Health Administration (VHA), along with the challenge of meeting their health-care needs in a historically male-focused setting, VHA has supported a variety of research projects aimed at evaluating and improving the status of women's health and health-care experiences. While these efforts have primarily focused on aspects of care such as the availability and accessibility of services and the provision of timely care, this study focused on the contribution of interpersonal aspects of care. Specifically, staff gender awareness, conceptualized as health-care workers' gender-role ideology or attitudes, gender sensitivity, and knowledge was examined. Findings revealed both strengths and weaknesses in domains of staff gender awareness and significant relationships between staff demographics and gender awareness components. [ABSTRACT FROM AUTHOR]

Educational research in recent decades has been characterized by an excessive emphasis on empiricism based on linear cause-effect relationships between variables. Recognizing the significant progress that empirical research has brought on school quality, the question arises whether its quality can truly be assessed and improved without regard to its intrinsic and contextual complexity. To answer this question research on school effectiveness is compared with the more holistic conception from the paradigm of complexity and chaos theory. Thus, the analysis of the meaning of complexity leads us to argue that the nature of the school is not analytic, stable and orderly, but systemic, dynamic and changing; so it requires a new narrative that teaches us to read and understand the roads that run between order and disorder in each educational process. Technical advances in computer simulation allow social researchers to move from the subjective metaphor to the use of a methodology of nonlinear systemic models that allows an interesting experiment of dynamic effects between variables, including key factors such as time. [ABSTRACT FROM AUTHOR]