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Background and objective: A network analysis can be used to quantitatively assess and graphically describe multiple interactions. This study applied network analyses to determine the interaction between physical and pain-related factors and fear of movement in people with whiplash-associated disorders (WAD) during periods of acute and chronic pain. Methods: Physical measurements, including pressure pain-thresholds (PPT) over neural structures, cervical range of motion, neck flexor and extensor endurance and the cranio-cervical flexion test (CCFT), in addition to subjective reports including the Tampa Scale of Kinesiophobia (TSK-11), Neck Disability Index (NDI) and neck pain and headache intensity, were assessed at baseline in 47 participants with acute WAD. TSK-11, NDI and pain intensity were assessed for the same participants 6 months later (n = 45). Two network analyses were conducted to estimate the associations between features at baseline and at 6 months and their centrality indices. Results: Both network analyses revealed that the greatest weight indices were found for NDI and CCFT at baseline and for neck pain and headache intensity and NDI and TSK-11 at both time points. Associations were also found betweeen cervical muscle endurance and neck pain intensity in the acute phase. Cervical muscle endurance assesssed during the acute phase was also associated with NDI after 6 months - whereas PPT measured at baseline was associsated with headache intensity after 6 months. Conclusion: The strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute pain and when mesured 6 months later. The extent of neck endurance and measures of PPT at baseline may be associated with neck disability and headache, respectively, 6 months after a whiplash injury. Significance: Through two network analyses, we evaluated the interaction between pain-related factors, fear of movement, neck disability and physical fac

The gut microbiome plays a key role in influencing several pathways and functions involved in human health, including metabolism, protection against infection, and immune regulation. Perturbation of the gut microbiome is recognised as a pathogenic factor in several gastrointestinal and extraintestinal disorders, and is increasingly considered as a therapeutic target in these conditions. Faecal microbiota transplantation (FMT) is the transfer of the microbiota from healthy screened stool donors into the gut of affected patients, and is a well-established and highly effective treatment for recurrent Clostridioides difficile infection. Despite the mechanisms of efficacy of FMT not being fully understood, it has been investigated in several chronic noncommunicable disorders, with variable results. This review aims to give an overview of mechanisms of efficacy of FMT in chronic noncommunicable disorders, and to paint the current landscape of its investigation in these medical conditions, including inflammatory bowel disease (IBD), chronic liver disorders, and also extraintestinal autoimmune conditions.

It has been recently estimated that the pattern of the global burden of diseases – expressed as disability-adjusted life years (DALY) – has changed over the last 20 years and a shift from communicable disorders to noncommunicable disorders has been observed. This shift is more pronounced in high-incomecountries. Even though there is lack of knowledge regarding the cause(s) behind the increase in chronic diseases/disorders, there are scientifically based suspicions that environmental factors do play an important role in interaction with genetic predisposition. Especially diffuse emissions of endocrine-disrupting compounds (EDCs) from consumer products are a matter of concern. The four reasons for concern with human EDC exposure are: The low-dose effect and a non-monotonic dose-response relationshipEarly life sensitivity and the persistency of effectsThe large number of EDC sources in our daily lifeThe wide range of health effects A full chain model is proposed which is following chemicals from their sources over environmental exposures in food, air, and dust over to human uptake and finally to human health effects. The model also includes modifying factors for environmental exposures, different pathways for human uptake, and biological mechanisms involved in health effects. With scientific information in this model risk management should be possible and result in preventive actions in order to reduce children’s exposure to health relevant factors. © Springer-Verlag Berlin Heidelberg 2014.

Chronic diseases such as type 1 diabetes (T1DM) and asthma are leading causes of morbidity and mortality worldwide. The increase in the number of children with chronic diseases is a major concern. Early detection through improved screening and diagnostic tests, better diagnosis based on updated guidelines, and improved drug therapy have led to more effective treatment of chronic illnesses.The studies included in this thesis focused on different aspects related to pediatric chronic disorders including T1DM, asthma and allergy. We have investigated the trends in prevalence and incidence rates of cardiovascular disease (CVD) risk factors, asthma and related-medications use in children with T1DM and evaluated genetic and environmental risk factors associated with the occurrence of childhood asthma, asthma exacerbations and allergy.Our studies in children with T1DM demonstrated that these children have higher prevalence rates of CVD risk factors and use of CV medication compared with age and gender-matched children without diabetes. The higher risk was already present one year before the onset of diabetes and further increased over the years of follow-up. However, there was substantial under-treatment of hypertension and hypercholesterolemia in children with T1DM. Our studies also showed a high rate of poor glycemic control (HbA1c>7.5% (58 mmol/mol)) in the pediatric population with T1DM. There are strong indications that genetic and environmental factors increase the risk of developing asthma and allergy in children. Our findings showed that a genetic risk score developed in adults with asthma also predicts asthma in children. The results of our meta-analysis including 34 published studies on the association between early life antibiotics use and the risk of long-term allergy suggested thatexposure to antibiotics during the first two years of life is associated with an increased risk of allergic symptoms including hay fever, eczema and food allergy later in life. Mor

BACKGROUND: Most people with epilepsy lead a normal emotional and cognitive life, however neurobehavioral problems can be found in a large number of patients. This study evaluates the prevalence of depression and anxiety among patients with epilepsy and determines whether having other chronic somatic illnesses increases the prevalence. METHODS: Adults with epilepsy were recruited in either the inpatient epilepsy monitoring unit or the Outpatient Epilepsy Clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, included data about age, sex, education, having other chronic illnesses, and degree of seizure control. The Hospital Anxiety and Depression scale was used to define the presence or absence of anxiety and depression. RESULTS: Two hundreds patients participated, with a mean age of 40.3±16 years. Nineteen (9.5%) patients had depression and 49 (24.5%) had anxiety. Age, seizure control, and having other chronic illnesses did not have a significant relationship with either depression or anxiety. Gender was significantly related to anxiety, with females displaying greater frequency of anxiety than males. Depression was inversely related to education. CONCLUSIONS: It is probable that people with higher education use more effective ways to psychologically and physically adapt to their illness.

Alcoholism has traditionally been viewed as a persistent and chronic disorder. Recent years, however, have seen a growing belief that the disorder can be completely transformed into stable, long-term improvement after intervention. Yet we know relatively little about the course of alcoholism over the long run. Although research has documented substantial rates of remission after treatment, the stability of such remission is very much an unanswered question. The purpose of this study is to extend knowledge about the remission process by examining the history of a sample of treated alcoholics over a period of 4 years. We find it is common for alcoholics to reach a state of remission, but that state is generally intermittent rather than stable. The study is based on a random sample of 922 males who made contact in 1973 with any one of eight Alcoholism Treatment Centers (ATCs} funded by the National Institute on Alcohol Abuse and Alcoholism The same cohort was interviewed in previous follow ups at 6 months and 18 months, and has been the subject of other research, including an earlier Rand study. At 4 years, information was obtained from 85 percent of the target sample. In addition to extensive interviews, the 4-year follow up data base included psychological tests, self reported psychiatric and medical information, measures of blood alcohol concentration, validation interviews with subject collaterals, and officially recorded causes of death for deceased subjects. Although all subjects had some contact with a treatment facility, the study was not an experimental evaluation of competing treatment methods. Rather, the principal objective was to trace the natural sequence of events, including treatment, in the course of alcoholism.

Granata, C., Jamnick, N. A., & Bishop, D. J. (2018). Principles of exercise prescription, and how they influence exercise-induced changes of transcription factors and other regulators of mitochondrial biogenesis. Sports Medicine, 48(7), 1541-1559. Available here

The need to adhere to recommended physical activity guidelines for a variety of chronic disorders calls for high precision Human Activity Recognition (HAR) systems. In the SelfBACK system, HAR is used to monitor activity types and intensities to enable self-management of low back pain (LBP). HAR is typically modelled as a classification task where sensor data associated with activity labels are used to train a classifier to predict future occurrences of those activities. An important consideration in HAR is whether to use training data from a general population (subject-independent), or personalised training data from the target user (subject-dependent). Previous evaluations have shown that using personalised data results in more accurate predictions. However, from a practical perspective, collecting sufficient training data from the end user may not be feasible. This has made using subject-independent data by far the more common approach in commercial HAR systems. In this paper, we introduce a novel approach which uses nearest neighbour similarity to identify examples from a subject-independent training set that are most similar to sample data obtained from the target user and uses these examples to generate a personalised model for the user. This nearest neighbour sampling approach enables us to avoid much of the practical limitations associated with training a classifier exclusively with user data, while still achieving the benefit of personalisation. Evaluations show our approach to significantly out perform a general subject-independent model by up to 5%.

Objectives: To identify profiles of aging combining psychological distress, cognition and functional disability and their associated factors. Methods: Data were drawn from the Étude sur la Santé des Aînés-Services longitudinal study and included 1585 older adults ≥ 65 years. Socio-demographic, psychosocial, lifestyle, physical, mental health were informed from structured interviews. Group-based multi-trajectory modelling and multinomial logistic regression were used to identify aging profiles and correlates. Sampling weights were applied to account for the sampling plan. Results: The weighted sample size was of 1591.Three trajectories were identified: a favorable (79.0%), intermediate (14.5%) and severe scenario (6.5%). Factors associated with the severe scenario were older age, male gender, lower education, the presence of anxiety disorders, low physical activity and smoking. Membership in the intermediate scenario was associated with daily hassles, chronic physical disorders, anxio-depressive disorders, antidepressants/psychotherapy use, low physical activity and no alcohol use. High social support was protective against less favorable profiles, as was primary care recruitment site. Conclusions: Symptoms of anxiety and depression and a high burden of chronic physical disorders were associated with less favorable trajectories. Modifiable lifestyle factors have a significant effect on healthy aging. Clinical implications: Assessment and management of anxiety and depressive symptoms are important in older adults. Clinical interventions including access to psychotherapy and promotion of healthier lifestyles should be considered.