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Little is known about the prevalence of young adult refugees' primary care use following resettlement in Colorado. Among a sample of Bhutanese and Burmese young adult refugees resettled in Colorado, proportions with a primary care provider (PCP), physical exam in the last 12 months, and knowledge to make an appointment were calculated across 4 years and compared within the refugee population by demographics using Pearson's Chi-Squared tests and compared to older refugees and to the general population using two-tailed tests of proportions. Greater than 70% of young adult refugees reported a physical exam in the last 12 months during the 4 years after arrival. Disparities were identified within young adult refugees by sex, marital status and country of origin. Young adult refugees were significantly different than both refugees over 55 and the general population in terms of their primary care use. Young adult refugees need support to identify PCPs earlier in resettlement and maintain primary care use years after resettlement. [ABSTRACT FROM AUTHOR]

Background: Sex-based differences have been largely uncharacterized for patients with borderline hip dysplasia (BHD) undergoing hip arthroscopy. Purpose: To evaluate for sex-based differences in clinical and pathologic characteristics as well as surgical outcomes in patients with BHD undergoing hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2011 and December 2018, data were prospectively collected on all patients with BHD undergoing primary hip arthroscopy. Patients were included if they had preoperative and minimum 2-year postoperative scores for the modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), and visual analog scale for pain. Patients with previous ipsilateral hip conditions or surgery, Tönnis grade >1, lateral center-edge angle <18° or >25°, or workers' compensation status were excluded. Patients were then divided by sex and propensity score matched in a 1:1 ratio for body mass index, age, and Tönnis grade. The rates of patients who achieved the minimal clinically important difference were recorded for the mHHS and NAHS. The rates of achieving the patient acceptable symptomatic state for the mHHS were calculated. Results: A total of 344 hips met the inclusion criteria, and 317 hips (92%) had adequate follow-up. Propensity score matching created cohorts of 109 male and 109 female patients. Male patients had significantly higher preoperative average alpha angles (69.79° vs 58.17°, P <.001), more often requiring a femoroplasty (97.2% vs 83.5%, P <.001), and had higher rates of complex labral tearing (50.5% vs 33.0%, P <.001). Male patients also had higher rates of grade 3 and 4 acetabular labral articular disruption (62.4% vs 19.3%, P <.001) and higher rates of grade 3 and 4 acetabular cartilage injury (59.6% vs 20.2%, P <.001) requiring a microfracture more frequently (32.1% vs 7.3%, P <.001). Female patients more typically had painful internal snapping requiring iliopsoas fractional lengthening (60.6% vs 32.1%, P <.001). Female patients also underwent capsular plication more regularly to address hip instability (79.8% vs 45.9%, P <.001). Male and female patients showed significant improvements in all outcome scores after surgery (P <.001). Female patients achieved the minimal clinically important difference for the NAHS at higher rates (85.3% vs 71.6%, P =.020). Conclusion: Female and male patients with BHD who underwent hip arthroscopy achieved favorable outcomes but had notably dissimilar pathology. Hence, although they share similar acetabular bony morphology, male and female patients with BHD may represent 2 very different pathologic entities. [ABSTRACT FROM AUTHOR]

Holland's RIASEC typology is a classification of vocational personality types and work environments. Having a predisposition for their vocation, in terms of a personality that is congruent to their work environment, may be protective for paramedics with regards to both their mental and physical health. The purpose of this study was to identify paramedicine students' vocational preference according to Holland's RIASEC model. Bachelor of Paramedicine degree students in the three different year levels completed the 48‐item Brief RIASEC Marker Scales to determine their order of the six RIASEC personality types. In this study, the paramedicine students' three most dominant personality types were Social‐Investigative‐Artistic, differing from the defined Holland Occupational Code for paramedics of Realistic‐Social‐Investigative. Male students scored significantly higher on the Reality personality type, whereas female students scored significantly higher on the Social personality type. Overall, this study found many students to possess two of the three dominant personality traits that form the desired Holland code for paramedics. This suggests that many students may be better able to cope with the demands of the paramedicine profession upon employment. [ABSTRACT FROM AUTHOR]

Objectives: 1) To determine which characteristics of adolescent athletes with SRC are associated with 'early' versus 'late' presentation for multimodal treatment; 2) to build a propensity score to investigate the effects of treatment timing during the management of SRCs. Methods: Associations between early (0-7 days) versus late (8-28 days) presentation for treatment and pre-specified sociodemographic, pre-injury and injury characteristics were investigated in a historical cohort study of 2949 multi-sport athletes across Canada aged 12-18 years diagnosed with a SRC in community-based healthcare clinics. Results: Early presentation was associated with being male, completing a pre-injury baseline assessment, and responding 'yes' or 'no' to having a diagnosed learning disability. Older athletes who reported previous SRCs were less likely to present early. The propensity score demonstrated an area under the curve of 0.71 (95% CI, 0.69 to 0.73). Conclusions: Male athletes with a completed baseline assessment were more likely to seek early treatment following a SRC, and older athletes who reported a greater number of previous SRCs were less likely to present early. External validation of the propensity score is needed before examining the impact of treatment timing on adolescent athlete recovery outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Speech-in-noise tests and suprathreshold auditory evoked potentials are promising biomarkers to diagnose cochlear synaptopathy (CS) in humans. This study investigated whether these biomarkers changed after recreational noise exposure. Method: The baseline auditory status of 19 normal-hearing young adults was analyzed using questionnaires, pure-tone audiometry, speech audiometry, and auditory evoked potentials. Nineteen subjects attended a music festival and completed the same tests again at Day 1, Day 3, and Day 5 after the music festival. Results: No significant relations were found between lifetime noise-exposure history and the hearing tests. Changes in biomarkers from the first session to the follow-up sessions were nonsignificant, except for speech audiometry, which showed a significant learning effect (performance improvement). Conclusions: Despite the individual variability in prefestival biomarkers, we did not observe changes related to the noise-exposure dose caused by the attended event. This can indicate the absence of noise exposure-driven CS in the study cohort, or reflect that biomarkers were not sensitive enough to detect mild CS. Future research should include a more diverse study cohort, dosimetry, and results from test-retest reliability studies to provide more insight into the relationship between recreational noise exposure and CS. Supplemental Material: https://doi.org/10.23641/asha.16821283 [ABSTRACT FROM AUTHOR]

Due to the coronavirus pandemic, online food purchases have increased. Nutrition labels and ingredients lists are important to assist individuals in making healthy food choices, but their provision is not mandatory for online stores in Hong Kong. This study aimed to investigate the prevalence of missing nutrition labels and ingredients list information on the e‐shops of major chain supermarkets in Hong Kong. Data from the e‐shops of four major chain supermarkets were collected using a bespoke web scraper program, which extracted the product page link, product name, brand, package size, ingredient list in text and product image links of every edible product available. A total of 22 365 products which were required by law to carry a food label on their packaging were included in the analysis. Prevalence of missing nutrition label or ingredients list on the respective product page was determined. Pearson's χ2 tests were used to test for differences in the prevalence between retailers. A two‐tailed p < 0.05 was considered statistically significant. Two e‐shops provided nutrition labels and ingredients list for none or only a negligible number of products. Overall, the prevalence of missing information was higher for nutrition labels than for ingredients lists (80.5% vs. 70.2%; p < 0.001). Provision of information varied greatly between stores and food categories. We found a high prevalence of missing nutrition labels and ingredients lists on e‐shops of major supermarkets in Hong Kong. Regulations on nutrition labelling should be extended to cover pre‐packaged food and beverages sold online. [ABSTRACT FROM AUTHOR]

Two studies investigating the impact of dried fruits eaten as a snack on weight control were designed to examine the effects of prunes and raisins on appetite (phase 1), and whether prunes undermine weight loss, due to the increase in energy density on drying, when included in a structured weight loss programme (phase 2). Phase 1 compared the effect on appetite of equi‐weight or equi‐caloric snacks of prunes (100 or 140 g) and raisins (100 or 111 g) with a control condition (100 g/335 kcal jelly babies), in a pre‐load, cross‐over design (n = 40 analysed). A significant effect of condition on food intake was observed, with significantly lower weight of food consumed in the 140 g prune group versus control, and on Area Under the Curve (AUC) fullness, due to a greater effect in the 140 g prune group versus control. In phase 2, change in bodyweight and waist circumference were measured in a 12‐week randomised, parallel‐groups intervention study (n = 100 analysed, 50 per group). Prunes (females: 140 g, males: 171 g/day) replaced usual snacks whilst following a weight loss programme. The active control group followed the same programme and participants were instructed on healthy snacking. A significant reduction in mean bodyweight in the prune group versus baseline was consistent with the phase 1 evidence that prunes can aid appetite control, although it could also be explained by overall diet in the context of a structured weight loss programme. Prunes did not produce a detrimental effect on mean weight loss over 12 weeks versus control (prune group: −1.99 kg; active control: −1.53 kg), nor on decrease in waist circumference (prune group: −2.40 cm; active control: −1.74 cm). No additional benefit on weight loss was seen (between‐group difference was non‐significant). The daily intake of prunes was well‐tolerated. Phase 1 demonstrated that prune snacks produced beneficial changes in appetite. Phase 2 demonstrated that prunes did not undermine weight management, and this warrants further study. [ABSTRACT FROM AUTHOR]

This study measured nurse and patient perceptions of three nursing care attributes—friendliness, courtesy, and respectfulness; comfort measures; and degree of information sharing—to better understand expectations and ensure satisfaction is met for every patient interaction. [ABSTRACT FROM AUTHOR]

Policy PointsIn 2012, Colorado and Washington were the first states to legalize recreational marijuana through voter‐initiated ballots. In these states, counties could restrict or ban local marijuana facilities through a variety of regulatory methods such as ordinances and zoning.County‐level recreational marijuana policies in Washington and Colorado vary substantially, with 69.2% of Washington counties and 23.4% of Colorado counties allowing all types of recreational marijuana facilities as of April 1, 2019.After Colorado and Washington legalized recreational marijuana, many counties modified their marijuana policies over time, with shifts in county policy often preceded by advocacy and information‐seeking activities. Context: In 2012, Colorado and Washington were the first states to legalize recreational marijuana. Both allowed local governments to further regulate the availability of marijuana facilities in their jurisdictions. As early adopters, these states are important quasi‐natural experiments to examine local marijuana policy and policy change processes, including key stakeholders and arguments. Methods: We conducted a policy scan of county‐level recreational marijuana ordinances and regulations in Colorado and Washington. Data collected included policy documents from counties in both states and newspaper articles. We used a mixed‐methods approach to describe the types of county‐level recreational marijuana policies enacted by April 1, 2019; identify key policy stakeholders involved in local policy debates; and explore arguments used in support or opposition of county policies. We also selected four counties that represent three county policy environments (all marijuana facility types allowed, some marijuana facility types allowed, all marijuana facility types prohibited) and described the policy changes within these counties since recreational marijuana was legalized. Findings: By April 1, 2019, Colorado counties were less likely than Washington counties to allow marijuana facilities—48.4% of Colorado counties prohibited recreational marijuana facilities in their jurisdiction compared to 23.1% of Washington counties. Since state legalization, several counties in both states have made substantial marijuana facility policy modifications, often preceded by information‐seeking activities. Primary stakeholders involved in policy debates included elected officials, law enforcement, individual growers/farmers, marijuana business license applicants, parents, and residents. Proponents referenced local economic gain, reduced crime, and potential health benefits of marijuana as arguments in favor of permitting local facilities, whereas opponents pointed to economic loss, negative health and public health issues, public safety concerns, and existing federal law. Both sides referenced local public opinion data to support their position. Conclusions: By early 2019, a patchwork of local marijuana policies was in place in Colorado and Washington. We identify key areas of policy and public health research needed to inform future local marijuana policy decisions, including the impact of legalization on public health outcomes (particularly for youth) and public safety. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the effects of nurse-led health coaching on adherence to health regimens and lifestyle factors among frequent attenders in primary health care. Methods: One hundred and ten patients were enrolled in the quasi-experimental study. The experimental group (n = 52) received nurse-led health coaching and the control group (n = 58) received conventional care at primary healthcare centres between 2015 and 2016. Data were collected before the intervention and 12 months afterwards using a questionnaire on adherence to health regimens and lifestyle factors. The intervention consisted of individual health coaching provided by a nurse, healthcoaching sessions, and a written action plan. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) dramatically increases the risk of both substance use disorder (SUD) and suicide in veterans. Military-related trauma, however, may not be the only or most significant trauma experienced by veterans. Trauma exposure is high among those joining the military. This study sought to identify the prevalence of five types of childhood trauma (emotional, physical, and sexual abuse and emotional and physical neglect) and three adult trauma symptom clusters (intrusive thoughts, avoidance, and hyperarousal) among veterans seeking SUD treatment and to clarify the associations between types of trauma and specific symptom clusters. Veterans at three Veterans Affairs (VA) SUD treatment facilities in the Midwest completed surveys at treatment entry (n 1 = 195) and at 6-month follow-up (n 2 = 138). Measures included the Childhood Trauma Questionnaire-Short Form and the PTSD Checklist, either a military or a civilian version, depending on whether the most traumatic event occurred in or out of the military. The prevalence of childhood trauma was high, ranging from 40.5% experiencing physical abuse down to 22.8% experiencing sexual abuse. At baseline, 60.2% of the military trauma group met criteria for PTSD, compared with 33.9% of the civilian trauma group, a significant difference, χ2(1, N = 195) = 14.46, p <.01. Childhood emotional and physical abuse were moderately associated with intrusion and hyperarousal in the military trauma group, but in the civilian trauma group a broader spectrum of childhood traumas were associated with a broader array of symptom clusters, including avoidance. At follow-up, symptoms improved and were less associated with childhood trauma. These findings illuminate the persistence of effects of childhood trauma and recommend more targeted PTSD treatments. [ABSTRACT FROM AUTHOR]

Introduction. Physical therapists (PTs) from various educational and clinical backgrounds are being hired to address the faculty shortage issue. Little is known about how junior PT faculty feel about their experiences in academia. the purpose of this study was to 1) explore current demographic and self-perceived experiences of junior faculty in PT education programs across the United States, 2) compare beliefs and experiences based on the highest academic degree held and the type of faculty line held, and 3) explore the relationships between job satisfaction and experiences in academia with the likelihood to remain in academia. Full-time junior faculty employed 5 years or less at accredited PT education programs. Methods: Descriptive correlational study using a 63-item, self-report, electronic, job satisfaction survey was sent to faculty employed at 223 accredited PT education programs in the United States. Results: Two hundred twenty-four fulltime junior faculty completed the survey. Respondents with clinical degrees were more satisfied in their position and more likely to stay in academia than those with terminal academic degrees. Similarly, respondents in nontenure-track positions were more satisfied and more likely to stay in academia than those in tenure-track positions. Social support, teaching, and scholarly activity mentorship were found to contribute to job satisfaction. Also, an association was found between job satisfaction and intention to remain in academia for all cohorts (rs ≥ 0.72; P = .001). Discussion and Conclusions: Junior PT faculty who received support and mentorship were more satisfied with their jobs and more likely to remain in academia. PT education programs should consider new or expanded mentorship programs for junior faculty, regardless of academic background, to promote professional progress, positive role-modeling, and faculty retention. [ABSTRACT FROM AUTHOR]

BACKGROUND: The SARS-CoV-2 pandemic increased the number of patients needing invasive mechanical ventilation, either through an endotracheal tube or through a tracheostomy. Tracheomalacia is a rare but potentially severe complication of mechanical ventilation, which can significantly complicate the weaning process. The aim of this study was to describe the strategies of airway management in mechanically ventilated patients with respiratory failure due to SARS-CoV-2, the incidence of severe tracheomalacia, and investigate the factors associated with its occurrence. METHODS: This retrospective, single-center study was performed in an Italian teaching hospital. All adult subjects admitted to the ICU between February 24, 2020, and June 30, 2020, treated with invasive mechanical ventilation for respiratory failure caused by SARS-CoV-2 were included. Clinical data were collected on the day of ICU admission, whereas information regarding airway management was collected daily. RESULTS: A total of 151 subjects were included in the study. On admission, ARDS severity was mild in 21%, moderate in 62%, and severe in 17% of the cases, with an overall mortality of 40%. A tracheostomy was performed in 73 (48%), open surgical technique in 54 (74%), and percutaneous Ciaglia technique in 19 (26%). Subjects who had a tracheostomy performed had, compared to the other subjects, a longer duration of mechanical ventilation and longer ICU and hospital stay. Tracheomalacia was diagnosed in 8 (5%). The factors associated with tracheomalacia were female sex, obesity, and tracheostomy. CONCLUSIONS: In our population, approximately 50% of subjects with ARDS due to SARS-CoV-2 were tracheostomized. Tracheostomized subjects had a longer ICU and hospital stay. In our population, 5% were diagnosed with tracheomalacia. This percentage is 10 times higher than what is reported in available literature, and the underlying mechanisms are not fully understood. [ABSTRACT FROM AUTHOR]

Background: The short-term application of negative pressure wound therapy with instillation and dwell time (NPWTi-d) enables the delivery of topical wound solutions, the solubilisation of debris and cleansing of the wound bed. The application of NPWTi-d may support the transition of the wound to a more manageable state and minimises the use of more invasive techniques. Method: In this case series, we describe the process of applying NPWTi-d early as part of a contaminated wound treatment plan. Results: The case series included 15 patients in the preoperative setting. Wound types included surgical dehiscence, hard-to-heal wounds, heel pressure ulcers, diabetic foot ulcers, a cat bite and an amputation left open. Normal saline or a 0.125% sodium hypochlorite solution were instilled and allowed to dwell for five minutes, followed by 15 minutes of continuous negative pressure at –125mmHg. NPWTi-d was continued for 4–36 hours, or until the operating room became available. After NPWTi-d, we observed a decreased amount of devitalised tissue in the wound bed and reduced oedema and erythema in the periwound area. Patient white blood cells also significantly decreased in all cases after NPWTi-d (p<0.001). Conclusion: Short-term use of NPWTi-d may be a useful option for supporting the surgical treatment of contaminated lower extremity wounds. [ABSTRACT FROM AUTHOR]

Background: African Americans in the general population have been shown to be less likely than White ethnic groups to participate in advance care planning; however, advance care planning in the population receiving dialysis has not been well explored. Objective: We examined the prevalence of African American patients receiving haemodialysis' advance care planning discussions, and whether advance care planning impacts end‐of‐life care preferences. Design: In‐person interviewer‐administered surveys of African American patients receiving in‐centre haemodialysis. Setting/Participants: About 101 participants at three large dialysis organisation units in Chicago. Outcomes: Self‐reported advance care planning and preferences for life‐extending treatments at end‐of‐life. Results: Most patients (69%) report no advance care planning discussions with their healthcare providers. Nearly all patients (92%) without prior advance care planning reported their healthcare providers approached them about advance care planning. While the majority of patients indicated preference for aggressive life‐extending care, prior conversations about end‐of‐life care wishes either with family members or a healthcare provider significantly decreased patients' likelihood of choosing aggressive life‐extending care across three scenarios (all p < 0.05). Significantly more patients reported that common end‐of‐life scenarios related to increased dependence/disability were "not worth living through" compared with those associated with increased burden on family, decreased cognitive function, and severe pain/discomfort. Conclusion: African Americans with end‐stage renal disease need more frequent, culturally‐sensitive advance care planning discussions. Despite a preference for aggressive life‐sustaining treatments, individuals with prior advance care planning discussions were significantly less likely to support aggressive end‐of‐life care. End‐of‐life care discussions that focus on the impact of life‐extending care on patients' independence could be more concordant with the values and priorities of the African American patients. [ABSTRACT FROM AUTHOR]

Objective: Psychological flexibility and fear of cancer recurrence are important variables that influence psychosocial outcomes in individuals diagnosed with a range of different types of cancer. Their role and how they impact on psychological distress and quality of life in men with prostate cancer specifically have not been established. Methods: A cross‐sectional sample of 144 men with prostate cancer was recruited. Multiple regression and conditional process analysis were used to assess whether psychological flexibility moderates the relationship between fear of recurrence and distress and quality of life. Results: Psychological flexibility significantly predicted psychological distress (β = −0.56, p < 0.0001) and quality of life (β = 0.21, p < 0.0001), appearing a stronger predictor of psychological distress than fear of recurrence (β = 0.25, p < 0.0001). Fear of recurrence was a stronger predictor of quality of life (β = −0.41, p < 0.0001) than psychological flexibility. Psychological flexibility moderated the relationship between fear of recurrence and psychological distress (β = −0.01, p < 0.001). At low and average levels of psychological flexibility, psychological distress mediated the relationship between fear of recurrence and quality of life (β = −0.33 to −0.16, p < 0.05). At high levels of psychological flexibility, distress no longer mediated this relationship (β = 0.01, ns), supporting the role of psychological flexibility as a moderator. Conclusions: These findings suggest that psychological flexibility might be a useful treatment target, through interventions such as Acceptance and Commitment Therapy, to buffer the effects of fear of recurrence and distress and improve psychosocial outcomes in this population. [ABSTRACT FROM AUTHOR]

Objective: Documenting vital signs and National Institutes of Health Stroke Scale (NIHSS) once every 15 minutes after intravenous thrombolytic therapy for acute ischemic stroke is often used as a metric to assess the quality of care. This study explores the association between "once every 15 minutes" documentation and stroke outcomes. Methods: This is a retrospective study of the first 2 hours of vital signs and NIHSS documentation after thrombolytic stroke therapy. Sociodemographic and clinical data, including NIHSS, temperature, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, and respiratory rate, were abstracted from the medical record. Missing documentation was examined for association with modified Rankin Scale (mRS) scores and neurologic changes. Result: Among 84 patients with a mean age of 68.8 years, there were 2276 documented assessments from an expected 3780. There were 104 clinically significant changes in 1 or more index variables. The most commonly missed documentation occurred during interventional radiology. After controlling for admission NIHSS, there was no significant relationship between the completeness of documentation and discharge mRS score (r² = 0.047, P = .0561), nor between vital sign documentation and discharge mRS (r² = 0.003, P = .6338). Conclusion: Frequency of documentation does not reflect the quality of care during the early phase of acute stroke treatment. [ABSTRACT FROM AUTHOR]

Background: Return to sports (RTS) and patient-reported outcomes (PROs) for high-level athletes after bilateral hip arthroscopy have not been well established. Purpose: (1) To report minimum 2-year PROs and RTS rates in high-level athletes who underwent staged bilateral primary hip arthroscopies and (2) to compare clinical results against a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for high-level athletes (professional, college, or high school) who underwent staged bilateral hip arthroscopy for femoroacetabular impingement syndrome between September 2009 and October 2018. Inclusion criteria were preoperative and minimum 2-year follow-up for modified Harris Hip Score, Non-arthritic Hip Score, Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and visual analog scale for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle <18°), and previous ipsilateral hip surgery/conditions. Rates of achieving the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold were recorded in addition to RTS. These athletes were then propensity matched in a 1:3 ratio to high-level athletes who underwent unilateral arthroscopy for comparison. Outcomes were compared among the first hip of the study group, the second hip of the study group, and the control group. Results: A total of 74 high-level athletes who underwent bilateral hip arthroscopy met the inclusion criteria, and follow-up was available for 68 (91.9%) at 58.9 ± 24.5 months (mean ± SD). Athletes undergoing bilateral hip arthroscopy returned to sports at a high rate (81.7%), demonstrated significant improvements in all recorded PROs, and achieved the MCID and PASS for the HOS-SSS at rates of 80.9% and 64.7%, respectively. PROs, RTS rate, and rates of achieving the MCID and PASS for the HOS-SSS were similar when the bilateral study group was compared with the unilateral control group (P >.05). Conclusion: High-level athletes who undergo staged bilateral primary hip arthroscopy for femoroacetabular impingement syndrome may expect favorable PROs and RTS rates at minimum 2-year follow-up. These results were comparable with those of a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy. [ABSTRACT FROM AUTHOR]

Background/Aims: The ability to climb stairs is an important prerequisite for activities of daily living and social participation in older adults, and is therefore an important part of rehabilitation. However, there is no consensus on how to measure stair-climbing ability. The aim of this study was to investigate the test–retest reliability of the measurement of stair-climbing speed (steps per second) as a parameter for functional ability in older adults. Methods: A total of 57 participants who were in hospital and 56 participants who were community-dwelling and did not have any limitations in activities in daily living, all aged 60 years and over, ascended and descended a set of 13 stairs twice. The halfway point of the staircase was marked in order to split the time required for both the ascending and the descending actions. Additional measurements consisted of the Functional Reach Test, the Timed Up and Go Test, walking ability using the GAITRite walkway system and the isometric strength of four muscle groups of the lower extremities using a handheld dynamometer. Results: Test–retest reliability of the first and second half of the stair-climbing for both ascending and descending showed excellent results for the group of hospitalised participants (intraclass correlation coefficient, [ICC] 0.87, 95% confidence interval [CI] 0.79–0.93 to 0.94, 95% CI 0.9 – 0.97 for comparison of first vs second half of stair climbing; ICC 0.9, 95% CI 0.83-0.94 to ICC 0.95, 95% CI 0.92–0.97 for comparing first vs second measurement)) and moderate to excellent results for the group of community-dwelling participants with no limitations (ICC 0.58, 95% CI 0.37–0.73 to ICC 0.76, 95% 95% CI 0.63-0.85 for comparison of first vs second half of stair climbing; ICC 0.82, 95% CI 0.71-0.89 to 0.92, 95% CI 0.87–0.95 for comparing first vs second measurement). As expected, hospitalised participants took significantly longer descending than ascending stairs (t(56)=6.98, P<0.001, d=0.93). A general and significant trend of increasing speed while descending could be observed in both groups (performing paired sample t-tests). Conclusions: The results indicate that stair-climbing speed is not constant and that different patterns exist in older adults who have no limitations and in those who are hospitalised. The use of stair-climbing speed as an assessment tool should include both stair ascent and descent, because differences in these speeds seem to be indicators of stair-climbing ability. [ABSTRACT FROM AUTHOR]

Objective: First responders play a crucial role in caring for patients with sepsis, as they are often first on the scene in emergency medical situations. Many first responders lack the advanced knowledge and skill set needed to identify patients with sepsis or those at risk for sepsis. Methods: This mixed-methods study examined if the implementation of a sepsis education program would impact and reduce the knowledge gap in first responders' ability to identify patients at risk for sepsis. Two hundred and thirteen first responders participated in an online sepsis education program, during which their knowledge was evaluated using a pretest and posttest. Results: The difference in the mean of the preeducation test scores and the posteducation test scores' mean was significantly different. The mean of the pretest scores was lower than the mean of the posttest scores, thus suggesting that the education of first responders is effective in increasing their knowledge of sepsis. After completing the program, participants felt better prepared to encounter instances of sepsis. Conclusion: standardizing communication between first responders and the emergency room through a "Sepsis Alert" can improve treatment times and allow for more timely intervention. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess the impact of a holistic combination of Occupational Therapy and Social Skills Training on occupational performance, social participation, and clinical symptoms in people with schizophrenia. Method: 60 people with schizophrenia were randomly assigned to two groups. One group received standardized Social Skills Training once a week for a total of 10 sessions, while the other group received a combination of Occupational Therapy and Social Skills Training once a week for a total of 16 sessions. Results: A greater increase was determined in the scores of COPM total performance/satisfaction and the Community Integration Questionnaire in the Occupational Therapy and Social Skills Training group. Furthermore, these achievements were sustained in the Occupational Therapy and Social Skills Training group compared to the Social Skills Training group at the 6-month follow-up. Conclusion: The clients received the combination of Occupational Therapy and Social Skills Training showed a better improvement compared to the Social Skills Training group in terms of occupational performance, social participation, and severity of clinical symptoms. The use of Occupational Therapy in a holistic approach in psychosocial rehabilitation of people with schizophrenia can increase their functionality and social participation. Further studies are needed to assess long-term effects of Occupational Therapy in schizophrenia. [ABSTRACT FROM AUTHOR]

Background Interactions between genetic and nutritional factors can contribute to the risk of gestational diabetes mellitus (GDM). Objectives We aimed to explore the associations of cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1 (CDKAL1) single-nucleotide polymorphism (SNP) rs7747752 and serum concentrations of SFAs with the risk of GDM in Chinese women. Methods We conducted a 1:1 case–control study in a prospective cohort of pregnant women in Tianjin, China. Serum SFA data were collected from a total of 243 women with GDM and their controls matched by maternal age (±1 y). Among them, 207 case–control pairs had high-quality sequencing data. P/L and S/P ratios were defined as palmitic acid (16:0)/lauric acid (12:0) and stearic acid (18:0)/palmitic acid, respectively. Conditional logistic regression analysis was performed to estimate associations of CDKAL1 SNP rs7747752 and serum concentrations of SFAs with the risk of GDM. An additive interaction between rs7747752 and palmitic acid was analyzed to test the contribution of their interaction to the risk of GDM. Results Among the 5 tested SFAs, palmitic acid was positively whereas lauric acid was negatively associated with the risk of GDM. A P/L ratio ≥12.2 and an S/P ratio ≤0.71 were independently and synergistically associated with an increased risk of GDM. The CDKAL1 rs7747752 G > C variant was significantly associated with an increased risk of GDM (P  < 0.05). Furthermore, the presence of the rs7747752 G > C variant increased the OR (95% CI) of high palmitic acid concentration from 1.55 (0.61, 3.97) to 4.34 (2.04, 9.23), with a significant additive interaction. Conclusions The interaction between high serum palmitic acid concentration and the CDKAL1 rs7747752 G > C variant played a critical role in GDM. Given that a hypocaloric low-carbohydrate diet can lower palmitic acid concentrations, it is worthwhile to test whether such a diet is effective in reducing the risk of GDM, especially among women who have both risk factors. [ABSTRACT FROM AUTHOR]

This is a retrospective cohort study using notification data in South Korea. We evaluated the nationwide status, regional differences, and the determinants of treatment outcomes among tuberculosis patients. Treatment success rate improved from 77.0% in 2012 to 86.0% in 2015. The lost to follow-up rate was higher among older people, males, and foreign nationals. Health care facilities designated for the Public-Private Mix (PPM) project showed higher success rate and lower rate of lost to follow-up. Moreover, municipalities with low regional deprivation index had higher PPM project coverage. Since there is a large regional difference in the coverage of the PPM project, an additional community-based support program should be implemented, especially for tuberculosis patients residing in region with low PPM project coverage. [ABSTRACT FROM AUTHOR]

Aims: To explore the codevelopment between loneliness and depression in older adults, and to identify its potential baseline individual, family and extrafamilial correlates. Background: The number of older adults around the world has steadily increased over the last decades. Later life is a particularly vulnerable life stage due to multiple unfavourable conditions, and mental health in this stage appears to become an inescapable issue. Previous research has found the cross‐sectional association between loneliness and depression, but their codevelopment has been understudied. Therefore, exploring the codevelopment and its correlates has significant implications for prevention and healthcare professionals. Design: A longitudinal follow‐up study. Methods: The study used nationally representative data over a 14‐year follow‐up period from the Taiwan Longitudinal Study on Ageing focused on Taiwanese aged 60 years and above (n = 4049). Group‐based trajectory modelling, group‐based dual‐trajectory modelling and multinomial logistic regression were the primary analytical methods. Results: We identified three distinct dual trajectories of loneliness and depression: longitudinal low‐frequency lonely depressed (29.3%), longitudinal moderate‐frequency lonely depressed (59.4%) and longitudinal high‐frequency lonely depressed (11.3%). After considering several demographic and background characteristics, difficulty in physical functioning, number of physical symptoms and diseases, sleep quality and number of child deaths were found to be significantly associated. Conclusion: Across the three identified dual‐trajectory groups, they all showed a stable loneliness frequency pattern over time; however, the moderate‐frequency group and high‐frequency group both had a trajectory of increasing depression. It seems that depression tends to change over time in a worsening direction, especially for those with a certain frequency of loneliness. Furthermore, differences in individual and family correlates were found across the groups. Implications for practice: Interventions focusing on the specific factors may help hinder coexisting loneliness and depression, and have implications for developing health promotion strategies and chronic disease care plans. [ABSTRACT FROM AUTHOR]

Background: Health science students in Spain should be trained to manage the process of death and dying. Aim: To compare the perceptions, attitudes and fears of death from a sample of these students. Methods: This descriptive, cross-sectional and multi-centre study comprised 411 students studying degrees in medicine, nursing and physiotherapy. The variables used were the hospice-related death self-efficacy scale by Robbins and the Collet-Lester fear of death scale. Findings: The total score obtained on the death self-efficacy scale was 74.43/110, which is considered moderate to high self-efficacy for facing death. Facing the death of a friend at a young age obtained the lowest score (3.85±2.809). Regarding the Collet-Lester scale, the lowest score was 'fear of one's own death' (3.58±0.983) with a value of p=0.81. Conclusion: The health science students who participated in this study displayed high levels of fear and anxiety towards death. [ABSTRACT FROM AUTHOR]

The 6-Minute Walking Test (6MWT) is a safe, standardized and well utilized method to assess the functional capacity. Recently, it was reported that the published prediction equations cannot accurately predict a valid maximal oxygen consumption (V̇O2 peak) value in cancer survivors. Thus, the aim of this study was to establish and to validate a new equation based on the 6MWT to predict V̇O2 peak in childhood acute lymphoblastic leukemia (ALL) survivors. A total of 200 childhood ALL survivors were enrolled in this study, among which 168 participants underwent a cardiopulmonary exercise test and a 6MWT to assess their functional capacity and their cardiorespiratory fitness. In addition, participants completed a physical activity questionnaire. Participants were randomly divided in two groups to establish the equations (n = 118 (70%)) and to validate it (n = 50 (30%)). Multiple linear regression analyses were used to determine a new prediction equation for V̇O2 peak from 6MWT using clinical and specific variables related to the disease. The accuracy in between V̇O2 peak measured and V̇O2 peak predicted were assessed using the Bland and Altman method. The new establish clinical V̇O2 peak equation is: V̇O2 peak (mL.kg−1.min−1) = (−0.283*age(years)) − (0.099*weight(kg)) + (0.071*6MWD(meters)) −(0.135*HR end(bpm)) + 22.789 with a mean bias of 2.67 mL.kg−1.min−1 (95% CI (−9.64 to 14.98)). The new establish disease-specific V̇O2 peak equation is: V̇O2 peak (mL.kg−1.min−1) = (−0.236*age(years)) − (0.094*weight(kg)) −(0.120*HR end(bpm)) + (0.067*6MWD(meters)) + (0.065*MVLPA(min/day)) − (0.204*DT(years)) + 25.145 with a mean bias of 2.51 mL.kg−1.min−1 (95% CI (−9.98 to 15.01)). This is the first study that predicted V̇O2 peak from a 6MWT using clinical and specific variables related to the disease of childhood ALL survivors. The availability of these newly established V̇O2 peak equations makes them an accurate tool to provide a better follow-up and better adapted physical training for survivors. We invite researchers to use our assessment procedures for their further studies. It is critical to understand the cardiorespiratory fitness of the childhood ALL survivors The maximal oxygen consumption (i.e., V̇O2 peak) is recognized as the gold standard to measure the patient's cardiorespiratory fitness in the field of exercise physiology This study is novel and reports the validation of two new VO2 peak equations, from 6MWT, by using clinical and disease-specific variables of childhood ALL survivors The availability of such validated equations can better facilitate the follow-up of survivors' cardiorespiratory fitness, by relevant health care professionals and exercise physiologists. [ABSTRACT FROM AUTHOR]

BACKGROUND: Evidence concerning the effects of greenness on childhood visual impairment is scarce. OBJECTIVES: We aimed to assess whether greenness surrounding schools was associated with visual impairment prevalence and visual acuity levels in Chinese schoolchildren and whether the associations might be explained by reduced air pollution. METHODS: In September 2013, we recruited 61,995 children and adolescents 6–18 years of age from 94 schools in seven provinces/municipalities in China. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI) from July to August 2013. Visual impairment was defined as at least one visual acuity level (dimensionless) lower than 4.9 (Snellen 5/6 equivalent). Three-year annual averages of particulate matter (PM) with an aerodynamic diameter of =1 lm (PM1) and nitrogen dioxide (NO2) at each school were assessed using machine learning methods. We used generalized linear mixed models to estimate the associations between greenness and prevalent visual impairment and visual acuity levels and used mediation analyses to explore the potential mediating role of air pollution. RESULTS: In the adjusted model, an interquartile range increase in NDVI500m was associated with lower odds of prevalent visual impairment [odds ratio (OR)=0.95; 95% confidence interval (CI): 0.93, 0.97]. The same increase in NDVI500m was also associated with 0.012 (95% CI: 0.008, 0.015) and 0.011 (95% CI: 0.007, 0.015) increases in visual acuity levels for left- and right-eye, respectively. Our results also suggested that PM1 and NO2 significantly mediated the association between NDVI500m and visual impairment. Similar effect estimates were observed for SAVI500m, and our estimates were generally robust in several sensitivity analyses. DISCUSSION: These findings suggest higher greenness surrounding schools might reduce the risk of visual impairment, possibly owing in part to lower PM1 and NO2 in vegetated areas. Further longitudinal studies with more precise greenness assessment are warranted to confirm these findings. https://doi.org/10.1289/EHP8429 [ABSTRACT FROM AUTHOR]

Insecure attachment orientations are disproportionately frequent in child sexual abuse (CSA) survivors and have been found to mediate some of the effects of CSA on adult interpersonal and romantic difficulties, including sexual revictimization (SR). A sense of relational entitlement (SRE) has received growing attention in psychological discourse and research in recent years. It reflects both adaptive (assertive) and pathological (restricted or inflated) attitudes to the assertion of needs and rights and has not been studied in adult CSA survivors. The purpose of this study was to examine associations between CSA, attachment orientations, SR, and SRE. Sixty-seven Israeli women aged 25 ± 3.95 years (30 adult CSA survivors and 37 healthy female controls with no history of CSA) completed a demographic questionnaire and self-reported measures of adult attachment orientations, sense of entitlement in romantic relationships, and adult SR. CSA survivors reported greater attachment anxiety and attachment avoidance, more restricted SRE, and higher revictimization rates than control women. No difference was found between the groups in inflated SRE. In the CSA but not the control group, anxious and avoidant attachment orientations were significantly and negatively associated with assertive SRE. Insecure (anxious and avoidant) attachment fully mediated the association between CSA and restricted SRE. Our findings suggest that the interplay between insecure attachment and CSA is related to a sense of impaired assertive entitlement and elevated restricted entitlement in adult CSA survivors. This entitlement pattern can be destructive to survivors' romantic relationships and should be addressed in therapy. [ABSTRACT FROM AUTHOR]

This study examined the moderating influences of active social networks (ASN), sedentary social networks (SSN) and ASN lost on the relationship between neighbourhood walkability and social activity in community-dwelling older adults aged 60 years or more in Accra, Ghana. A total of 863 individuals participated after G*Power 3.1 was utilized to calculate the minimum sample size. We analysed the data with Pearson's correlation test and hierarchical linear regression models. A sensitivity analysis was conducted to select the ultimate confounding variables. The study found a positive influence of neighbourhood walkability on social activity after the covariate adjustment (β = 0.18; t  =   5.2; p  = 0.000). The positive influence of neighbourhood walkability on social activity was significantly reduced by ASN lost and SSN. ASN did not have a significant moderating influence on the primary relationship. The study concludes that the positive influence of walkable neighbourhoods on social activity decreases as SSN and ASN lost increase. [ABSTRACT FROM AUTHOR]

Background Limitations in passive hip range of motion (PROM) may negatively affect pitching mechanics in baseball pitchers. Understanding the relationships between PROM and mechanics can assist in the development of injury prevention protocols. Purpose The purpose of this study was to examine the association of hip rotational PROM with pelvis and trunk rotation during pitching in high school baseball pitchers. Study Design: Cross-sectional. Methods Twenty-five healthy high school baseball pitchers volunteered (15.9 ± 1.1 years; 180.4 ± 5.5 cm; 75.4 ± 9.3 kg). Seated passive hip internal rotation (IR) and external rotation (ER) PROM were measured using a digital inclinometer. Total PROM was calculated (IR+ER). Pitching biomechanical data were collected with a 3-dimensional electromagnetic tracking system while pitchers threw fastballs. Simple linear regressions were performed to examine the association between hip IR, ER, and total PROM with pitching kinematics at foot contact including stride length, pelvis rotation, and trunk rotation. Results Only one significant association in PROM and kinematics was observed. Drive leg hip IR PROM was associated with trunk rotation angle [F(1,24) = 4.936, p = 0.036], with an R2 = 0.177. Drive leg total PROM was not associated trunk rotation angle [F(1,24) = 4.144, p = 0.053] with an R2 = 0.153. Conclusions Increased drive leg hip IR PROM was associated with decreased trunk rotation towards home plate. Hip total PROM and ER were not related to pitching mechanics. [ABSTRACT FROM AUTHOR]

Conservative surgery (CS) is a safe procedure to arrest the bone infection in cases of diabetic foot osteomyelitis (DFO). The authors conducted a case-control study of 83 patients with DFO who underwent CS as the first attempt to arrest the bone infection and presented with a failure of this surgical approach. CS failed in 21 patients (25.3%) and required amputations; 15 minors (18%) and six majors (7.3%). The factors associated with failure of conservative surgery and subsequent amputation were isolation of Pseudomonadacea in bone cultures, and soft tissue involvement. Just three out of 44 patients (6.8%) had a failure of CS, and none of them underwent a major amputation when patients with osteomyelitis without soft tissue infections were analysed separately. [ABSTRACT FROM AUTHOR]

Background The ongoing COVID-19 pandemic has resulted in a sharp rise in demand for healthcare workers worldwide. This has been coupled with reduced numbers of available medical professionals due to confirmed or suspected infections with SARS-CoV-2. To counteract these shortages, governments of several countries have considered the enrolment of medical students into the workforce in order to help to tackle the ongoing crisis. Methods Questionnaire-based study assessing the perceived role of medical students in assisting in the COVID-19 pandemic. The primary aim was to determine factors contributing to the willingness of medical students to actively assist in the pandemic. The secondary aim was to evaluate their perspectives regarding the associated changes in medical education. Results Out of 760 responses, 71.18% of medical students were willing to assist the medical workforce during the pandemic. Clinical year students were more likely to help in a medical capacity than pre-clinical students (OR = 0.384, 95%CI [0.167, 0.883, P  < 0.05)]. Respondents concerned about their own well-being were less likely to engage in clinical work (OR = 0.680, 95%CI [0.491, 0.941], P  < 0.020). Students who agreed that online lectures will negatively impact their education were inclined to think that the academic year should be extended (95%CI [0.065, 0.271], P  = 0.001). Conclusions Most students are willing to help in both a medical and non-medical capacity. Their primary concerns when working in a medical setting are the risk of infecting their relatives and patients, lack of protective equipment and necessary knowledge as well as legal uncertainty whilst working without a medical qualification. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is the leading cause of death and disability in Egypt. An appropriate estimation of risk is important to improve cardiovascular outcomes and ensure efficient allocation of resources used to support disease prevention. Risk prediction charts have been developed to provide clinicians with a simple tool to estimate the absolute risk of developing coronary heart disease (CHD). Objectives: To test the accuracy of the World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in predicting and identifying people at risk of developing CHD and to propose an alternative risk assessment instrument based on simple laboratory tests, routine examination, and reported personal and medical data. Methods: A cross-sectional screening survey was conducted at an emergency department of a health insurance hospital in Alexandria, Egypt. A total of 350 enrolled patients were evaluated clinically. We applied the WHO/ISH risk assessment chart for the Eastern Mediterranean region to test its accuracy in predicting CHD. Results: The validation statistics indicated that the WHO/ISH risk prediction charts identified cases with CHD with 60.0% sensitivity and 93.2% specificity. At least nine risk factors for developing CHD were detected in all patients in the study cohort. Hypertension was the strongest predictor of CHD [odds ratio (OR) (95% confidence interval (CI)): 20.8 (5.6–76.9)]. Silent cardiovascular risk factors were ascertained in about 30% of the studied population, a finding that did not differ significantly by sex. We propose a different risk assessment model for general practice that incorporates standard cardiovascular risk factors, with or without laboratory tests. Conclusions: Standard cardiovascular risk factors included in a simple risk prediction algorithm can predict multivariate CHD risk in apparently healthy individuals. Non-laboratory-based risk assessment models have no superior advantage over those employing laboratory investigations. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between static and dynamic postural stability and functional disability associated with chronic low back pain (CLBP). Methods: A total of 80 patients (age 44.64 ± 1.27 years) were recruited in this cross sectional study using convenience sampling. The One Leg Stand Test (OLST) was used to assess static balance with eyes open and eyes closed; Y Balance Test- Lower Quarter (YBT-LQ) was used to assess dynamic balance in the anterior, posterolateral and posteromedial directions; and functional disability was assessed using modified Oswestry Disability Index (mODI). Karl Pearson correlation coefficient was used to estimate the relationship between the variables. Results and Conclusion: mODI was negatively correlated to OLST with eyes closed (r= -0.721); YBTLQ composite score (r= -0.865); and reach distances in the posterolateral (r= -0.815) and posteromedial (r= -0.832) directions suggesting that control of postural stability was reduced with an increase in disability in patients with CLBP. [ABSTRACT FROM AUTHOR]

In 2015, South Carolina passed the Domestic Violence Reform Act giving officers increased arrest discretion and rescinding mandatory arrest laws for intimate partner violence (IPV). Analyses using incident reports (2016/2017) from South Carolina show that officers primarily rely on the presence of five variables to determine arrest: children, injury, property destruction, offender at scene, and weapons. Cases with Black female victims are more likely to result in arrest, suggesting that Black males are being criminalized. We conclude that officers are reluctant to use individual discretion and rely on a form of structured discretion provided by administrators that shapes local culture and decision-making. [ABSTRACT FROM AUTHOR]

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Three experiments were conducted to test whether an enhanced degree of fair behavior could be obtained by making justice a goal, whether consciously set, primed, or both. Each experiment assessed fairness in a competitive negotiation context. All participants, across the three experiments, were asked to attain a base-level performance goal. The first experiment examined how a negotiation is affected by a consciously set goal for fairness as well as a primed fairness goal. The results revealed that both the conscious and the primed goal enhanced a participant's fairness. The second and third experiments examined the underlying mediating mechanisms of the effects found in the first experiment. Overall, the results of three experiments indicate that both conscious and primed goals, individually or in combination, can increase fair behavior by enhancing justice saliency. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

A central dental implant success criterion is the marginal bone response as measured longitudinally. Factors that influence marginal bone changes include osseous and soft tissue architecture, occlusal loading factors, implant position, implant design, and inflammatory processes. The evolution of implant design is multifactorial and includes the implant-abutment interface geometries. The primary objective of this study was to compare the proximal marginal bone changes following placement and loading of internal conus design implants (ICI) and external hex design implants (EXI) used in the treatment of posterior partial edentulism. Among 45 enrolled participants, 39 were treated with 47 ICI or 46 EXI implants using a one-stage implant protocol. Prosthetic restoration was completed after 12 weeks using stock titanium abutments and all-ceramic crowns. Follow-up visits including clinical and radiographic examinations were performed 6 months after permanent restoration and then annually for 3 years. Marginal bone level changes, papilla index scores, condition of the peri-implant mucosa, presence of complications, and participant satisfaction were evaluated. The mean marginal bone level change from implant placement to 3 years was –0.25 ± 0.60 mm and –0.5 ± 0.93 mm for ICI and EXI implants, respectively. The change recorded from permanent restoration to 3 years was a gain of 0.31 ± 0.41 mm versus 0.04 ± 0.51 mm for ICI and EXI implants, respectively (P < .05). In the evaluation of interproximal soft tissue 3 years after permanent restoration, 80% of mandibular and 66% of maxillary interproximal ICI sites received papilla scores of 2 and 3, compared with 50% of mandibular and 60% of maxillary interproximal EXI sites. No significant differences in plaque or bleeding scores were recorded. Abutment/healing abutment complications were recorded for 11 EXI versus 1 ICI participant. The vast majority (> 90%) of participants stated they were satisfied or very satisfied with their implant prosthesis and rated function and esthetics highly for both implant types after 3 years in function. Modestly greater marginal bone loss occurred at EXI implants. Further, more positive papilla scores were found between adjacent ICI implants than between adjacent EXI implants. EXI implants displayed more abutment complications than the ICI implants. The implant-abutment interface design may contribute to therapeutic outcome differences. Replacement of missing posterior teeth with unsplinted implants was successful at the implant level and as reported by the participant. [ABSTRACT FROM AUTHOR]

Purpose: To report the clinical and radiographic outcomes of a 3-year follow-up of immediately and early loaded two-implant-supported mandibular overdentures. Materials and Methods: Forty edentulous patients were randomly subdivided into two groups. In the immediate loading group, two Straumann implants were splinted with a Dolder bar and loaded with a mandibular overdenture within the first 48 hours postoperative. In the early loading group, the two implants were loaded with an overdenture 6 weeks postoperative. Standardized intraoral radiographs using a film holder were obtained at 1 month and 3 years. Two independent observers assessed marginal bone loss twice, independently, and analysis of variance (ANOVA) was used to follow up marginal bone level changes. Results: In total, there were 26 remaining patients available at the 3-year followup (15 immediate and 11 early). One implant was lost in the early loading group, and no implants were lost in the immediate loading group. All superstructures and dentures were adequately functional at the 3-year control. Mean radiographic marginal bone loss between baseline and the 3-year follow-up was 0.35 ± 0.63 mm for immediately loaded implants and 0.31 ± 0.96 mm for early loaded implants. The difference between the two groups was not statistically significant (P = .26). Conclusion: Within the limitations of this trial and the short follow-up period and high dropout rate, the immediate loading protocol was found to be comparable in its clinical and radiographic outcomes to the early loading protocol for the two-implant Dolder bar-supported mandibular overdentures. [ABSTRACT FROM AUTHOR]

Purpose: To investigate differences in running activities between adolescent and adult tennis players during match play. Differences between winning and losing players within each age group were also examined. Methods: Forty well-trained male players (20 adolescents, 13 ± 1 y; 20 adults, 25 ± 4 y) played a simulated singles match against an opponent of similar age and ability. Running activities were assessed using portable devices that sampled global positioning system (10 Hz) and inertial-sensor (accelerometer, gyroscope, and magnetometer; 100 Hz) data. Recorded data were examined in terms of velocity, acceleration, deceleration, metabolic power, PlayerLoad, and number of accelerations toward the net and the forehand and backhand corners. Results: Adult players spent more time at high velocity (≥4 m/s²), acceleration (≥4 m/s²), deceleration (≤-4 m/s²), and metabolic power (≥20 W/kg) (P ≤ .009, ES = 0.9-1.5) and performed more accelerations (≥2 m/s²) toward the backhand corner (P < .001, ES = 2.6-2.7). No differences between adolescent winning and losing players were evident overall (P ≥ .198, ES = 0.0-0.6). Adult winning players performed more accelerations (2 to <4 m/s²) toward the forehand corner (P = .026, ES = 1.2), whereas adult losing players completed more accelerations (≥2 m/s²) toward the backhand corner (P ≤ .042, ES = 0.9). Conclusions: This study shows that differences in running activities between adolescent and adult tennis players exist in high-intensity measures during simulated match play. Furthermore, differences between adolescent and adult players, and also between adult winning and losing players, are present in terms of movement directions. Our findings may be helpful for coaches to design different training drills for both age groups of players. [ABSTRACT FROM AUTHOR]

Context: The forward-step-down (FSD) test may be used to identify underlying pathologies related to lower-extremity injuries. However, research on its interrater reliability is limited. Objective: To assess the interrater reliability of the FSD test with a broad cohort of clinicians and to compare the level of agreement with an expert panel. Design: Single-measure, interrater reliability. Setting: Annual conference of the Israeli Physical Therapy Society. Participants: 15 healthy subjects who performed the FSD test and 142 physical therapists (PTs) who evaluated performance. Methods: Each subject performed the FSD while being videoed. Six videos were selected by an expert panel for analysis. After viewing the videos, FSD performance was rated by 142 PTs, as well as by the expert panel, using a 3-level scale. Main Outcome Measures: Interrater reliability determined by intraclass correlation coefficient (ICC) and percentage of agreement with the expert panel. Results: Fair to good reliability and acceptable agreement were found for the entire sample of raters (ICC -.61, agreement 74%). The percentage of agreement was greater in the subgroup of raters who were familiar with the FSD than in those who were not (78.08% vs 69.32%, respectively, P = .004). Years of work experience did not affect the percentage of agreement (P = .141). Conclusions: Fair to good interrater reliably of the FSD test was demonstrated by a broad cohort of PTs. The findings support the clinical utility of the FSD test as an assessment tool for quality of movement. [ABSTRACT FROM AUTHOR]

Purpose: There are few reliable studies assessing the effect of physical exercise (PE) on adipokines levels at young ages. Our objective was to study the effects of regular PE on plasma adipokines in pediatric overweight and obesity. Method. 117 overweight and obese children and adolescents (47% females; 10.2 years) participated in an 8-month longitudinal study divided in two groups: PE group (n = 80), engaged in an after-school PE program; control group (n = 37), with no PE program. Plasma lipids, C-reactive protein (CRP), adiponectin, resistin, leptin, IL-6, IL-lbeta, TNF-alpha, insulin and glucose levels were determined. Results, contrarily to the control group, the PE group presented reductions in body mass index z-score (BMIzsc) and body fat percentage that were accompanied by an improvement in lipid profile and insulin resistance, a reduction in CRP and TNF-alpha and an increase in adiponectin levels. The reductions in BMIzsc were inversely correlated with changes in adiponectin (r=-0.329, p - .003) and positively correlated with changes in percentage body fat (r = .262, p = .032), triglycerides (r = .228, p = .042) and leptin (r = .285, p = .010). Conclusions. Moderate reductions in adiposity improve proinflammatory status in obese children and adolescents. A more substantial reduction in BMIzsc was associated with a greater increment in adiponeclin and reduction in leptin. [ABSTRACT FROM AUTHOR]

The present study should reveal differences in gait performance, quadriceps strength, and physical activity (PA) between fallers and nonfallers in women with osteoporosis. Forty-one women with osteoporosis (17 fallers, 24 nonfallers) participated. Gait analysis shows that fallers were walking with a slower walking speed (−9%, p = .033) and had a shorter stride length (−7%, p = .039). Moreover, fallers showed a decreased ankle power generation (−18%, p = .045). The quadriceps strength was decreased by 24% for fallers (p = .005) while PA showed no significant differences. Although a decrease in ankle power generation could have an effect on floor clearance for limb advancement in the swing phase, the causal relationship between spatiotemporal parameters (walking speed, stride length) and walking ankle joint power generation remains unknown and warrants further investigation. In conclusion, walking speed, stride length, ankle power generation, and quadriceps strength can be used to differentiate between fallers and nonfallers in women with osteoporosis. [ABSTRACT FROM AUTHOR]

Objective: The beneficial effects of antiseptics in the treatment of periodontitis are still controversial. The goal of this randomized split-mouth study was to evaluate the clinical and microbiologic results of a unique subgingival irrigation of 10% povidone-iodine in addition to a full-mouth scaling and root planing for the treatment of chronic periodontitis. Method and Materials: Twenty patients with chronic periodontitis took part in this investigation. In each patient, four initially untreated pockets > 4 mm were randomly selected for one subgingival irrigation. After a one-session full-mouth treatment with scaling and root planing (SRP), two pockets of a split mouth received one unique irrigation with 10 mL 0.9% NaCl solution (control group, CG). Two pockets on the other side received 10 mL of povidone-iodine 10% (test group, PIG). Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) parameters were assessed at baseline and after 1, 3, and 6 months (M). Bacterial samplings with sterile paper points were taken at M0 and after M1, M3, and M6. These samplings were separately cultured under aerobic and anaerobic conditions before CFU evaluation. Results: Pl, GI, PPD, and CAL were significantly improved in both groups after 6 months. The major difference was seen between M0 and M3 (P<.001). No significant differences were seen between the groups, except for deep pockets (> 6 mm) where a statistical difference was observed in favor of PIG after 6 months; in these subgroups the mean probing reduction was 2.68 ± 0.37 mm for CG versus 3.93 ±0.23 mm in PIG (P<.001). No significant differences were seen between CG and PIG regarding the microbiologic results after 6 months. Conclusion: One single irrigation of 10% povidone-iodine associated with full-mouth SRP would bring a small additional benefit in deep pockets. More studies are needed to yield additional results. [ABSTRACT FROM AUTHOR]

In the United States, the labor force continues to age. As age increases, so does the likeliness of needing disability accommodation. Prior research indicates that people with disabilities often do not request needed accommodations when they assess that others at work would perceive a request as normatively inappropriate. Little, however, is currently known about the impact of age on these assessments. In this study, we integrate prior research on age, disability, social identity, and climate to propose and then test a model of the relationship between requesters' age and their normative assessments using survey data from 242 people who became hearing impaired prior to entering the workforce. As hypothesized, requester age was negatively associated with normative appropriateness assessment favorability. Moreover, this negative influence was stronger in for profit organizational contexts and in workgroup contexts in which the requester lacked a coworker with a disability. Having a coworker with a similar disability also partially mediated the moderating effect of organization type on the association between age and normative appropriateness assessment favorability. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

A minimum level of activity likely to improve sleep outcomes among older people has not previously been explored. In a representative UK sample aged 65+ (n = 926), cross-sectional regressions controlling for appropriate confounders showed that walking at or above the internationally recommended threshold of ≥ 150 min per week was significantly associated with a lower likelihood of reporting insomnia symptoms (OR = 0.67, 95% CI = 0.45−0.91, p < .05). At a 4-year follow-up (n = 577), higher walking levels at baseline significantly predicted a lower likelihood of reporting sleep onset (OR = 0.64, 95% CI = 0.42−0.97, p < .05) or sleep maintenance (OR = 0.63, 95% CI = 0.41−0.95, p < .05) problems. These results are consistent with the conclusion that current physical activity guidelines can support sleep quality in older adults. [ABSTRACT FROM AUTHOR]

Purpose: To examine pacing strategies of ultracyclists competing in the Race Across AMerica (RAAM), the world's longest ultracycling race, covering ~4860 km from the West to the East coast of America. Methods: Age, cycling speed at and across time stations, race distance, relative difference in altitude between time stations, wind velocity, wind gradient, and temperature at each time station were recorded for women and men competing from 2010 to 2014. Changes in cycling speed and power output of elite and age-group finishers were analyzed using mixed-effects regression analyses. Results: Cycling speed decreased across time stations for women and men where men were faster than women. Power output decreased across time stations in women and men and was lower for women for all finishers, the annual 3 fastest, and age group 60-69 y but not for age groups 18-49 and 50-59 y. The change in temperature and altitude had an influence on cycling speed and power output in all finishers, the annual top 3, nonfinishers, and in all different age groups for both women and men but in the age group 50-59 y altitude had no influence on cycling speed. Conclusions: Positive pacing (ie, decrease in speed throughout the race) seemed to be the adequate strategy in the RAAM. The top 3 finishers started faster and had a higher power output at the start than less successful competitors, achieved the highest peak cycling speeds and power output, and maintained peak cycling speed and power output longer before slowing down. [ABSTRACT FROM AUTHOR]

Different corticotomy surgical procedures have been developed to shorten orthodontic treatment times by stimulating bone remodeling. Although all corticotomy procedures involve physical injury to the bone, the clinical outcomes can vary. Using an ex vivo calvarial bone organ culture model system, the authors evaluated the biologic response of bone to different corticotomies. Bone injuries were generated in 276 calvaria dissected from 5- to 7-day-old neonatal mice using a piezoelectric knife, a bur, and a handheld screw device. The responses were evaluated using chemical, biochemical, and global histomorphometric analyses. Injuries generated by the three approaches induced varying degrees of bone remodeling activities; however, the piezoelectric knife led to the most extensive impact in both bone resorption and formation models. [ABSTRACT FROM AUTHOR]

This study aimed to test the null hypothesis that platelet-rich fibrin (PRF), as an immediate postextraction graft material, produces bone that is histomorphometrically no different than bone derived from healing without intervention. The authors compared split-mouth human bone biopsy specimens derived from PRF with bone that had healed without intervention. Eight human bone biopsies were successfully harvested from four patients. The mean ± standard deviation (SD) percent of newly formed osteoid was 9.9% ± 5.9% for specimens derived from PRF, and 4% ± 2.1% for specimens derived from the control sites (P = .089; 95% confidence interval [CI] 4.5–18.1 and 1.6–6.6, respectively). Mean ± SD percent of new mineralized bone was 40.8% ± 10.3% for the PRF specimens and 43.9% ± 16.8% for the control specimens (P = .72, 95% CI, 33.4–55.6 and 19.3–55.5, respectively). Newly formed bone to fibrovascular tissue ratios for specimens in the PRF and control groups were 51%:49% and 48%:52%, respectively. Within the limitations of this study, the null hypothesis could not be rejected. Bone derived from PRF histologically did not differ from bone that healed without intervention. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated associations between weather conditions, physical activity, and sedentary time in primary school-aged children in Australia and Canada. Methods: Cross-sectional data on 9-11-year-old children from the Australian (n = 491 ) and Canadian (n = 524) sites of the International Study of Childhood Obesity, Lifestyle and the Environment were used. Minutes of daily moderate-to-vigorous-physical-activity (MVPA) and sedentary time were determined from 7-day, 24-h accelerometry (Actigraph GT3X+ triaxial accelerometer). Day-matched weather data (temperature, rainfall, snowfall, relative humidity, wind speed) were obtained from the closest weather station to participants' schools. Covariates included parental highest education level, day type, sex, and BMI z-scores. Generalized mixed model analyses allowing for clustering of participants within schools were completed. Scatterplots with Loess curves were created for maximum temperature, MVPA, and sedentary time. Results: Daily maximum temperature was significantly associated with MVPA and sedentary time in Australia (MVPA p = .05, sedentary p = .01) and Canada (p < .001, p = .001). Rainfall was negatively associated with MVPA in Australia (p < .001) and positively associated with sedentary time in Canada (p = .02). Conclusions: MVPA and sedentary time appear to be optimal when the maximum temperature ranges between 20°C and 25°C in both countries. The findings have implications for study design and interpretation for surveillance and intervention studies. [ABSTRACT FROM AUTHOR]