Falls and mobility in Parkinson’s disease : protocol for a randomised controlled clinical trial

Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson's disease, this has not yet been confirmed with a large scale randomised controlled clinical trial. The study will investigate the effects on falls, mobility and quality of life of (i) movement strategy training combined with falls prevention education, (ii) progressive resistance strength training combined with falls prevention education, (iii) a generic life-skills social program (control group).
Methods/Design People with idiopathic Parkinson's disease who live at home will be recruited and randomly allocated to one of three groups. Each person shall receive therapy in an out-patient setting in groups of 3-4. Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks. All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase. Assessments will occur before therapy, after the 8 week therapy program, and at 3 and 12 months after the intervention. A falls calendar will be kept by each participant for 12 months after outpatient therapy. Consistent with the recommendations of the Prevention of Falls Network Europe group, three falls variables will be used as the primary outcome measures: the number of fallers, the number of multiple fallers and the falls rate. In addition to quantifying falls, we shall measure mobility, activity limitations and quality of life as secondary outcomes.
Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson's disease who live at home.

Social stratification and mobility in Guatemala

Includes bibliography

Disability and mobility: interaction of two public policies for sustainable development

This issue of the FAL Bulletin analyses institutional alternatives and international best practices for the development of transportation services that explicitly include and integrate users with some type of disability.

Convergence and divergence of transport and mobility policies in Latin America: Lack of urban co-modality

This issue of the FAL bulletin analyses transport and mobility policy in Latin America, where the lack of integrated public policies for urban mobility and the failure to take coordinated action over time make it difficult to prioritize investments and coordinate existing initiatives (both public and private).

Developing integrated and sustainable policies on infrastructure, logistics and mobility in Mesoamerica

This issue of the FAL Bulletin summarizes the main outcomes of a regional workshop held in Costa Rica in November 2012 that brought together ministers and high-level authorities from the member countries of the Mesoamerica Project.

Energy efficiency and mobility: A roadmap towards a greener economy in Latin America and the Caribbean

Much analysis and proposals on sustainable transport policies have been developed around the world, both at government and research institutions. It is clear that no action will provide the single solution and it is imperative to act simultaneously on: i) improvement of technology in vehicles, leading to increased energy efficiency; ii) the change in driver behavior, to use less fuel per kilometer; iii) reducing the distances traveled per vehicle; and iv) a change in the type of travels towards more sustainable modes of transport.In general, the recommendations for energy efficiency in transport are mainly focused on the first two priorities on the list, while the portfolios of policies —instrumental to the needs of the countries— should use trans-sectoral and multi-dimensional approaches, such as public transport planning and land use. In ECLAC, we consider that the time has come to provide Latin American and Caribbean countries with a deeper understanding and a more strategic vision (and adapted to the realities of the region) on these issues; in this sense, we hope that this document will help countries to improve and further expand their portfolios of energy efficiency policies in the transport sector, in order to achieve the ambitious goals of energy efficiency, needed to ensure a sustainable energy future.

Logistics and mobility policies for sustainable development and regional integration: conceptual framework and regional experiences

This FAL Bulletin summarizes the main findings and proposals contained in the document “Políticas de logística y movilidad para el desarrollo sostenible y la integración regional”, recently published by the Natural Resources and Infrastructure Division (NRID), ECLAC. It contains a proposal for a paradigm shift in the formulation of national logistics and mobility policies, with common guidelines for Latin American and Caribbean countries.

Strategies used by the children's education teacher for orientation and mobility of the visually impaired student

This study aims to identify, describe, and analyse strategies used by a teacher to support the mobility of students with visual impairment in various school environments. A female student with visual impairment in Brazil, aged 5 years, and her classroom teacher participated in the study. Their interactions were videotaped, and later, their dialogue and actions were transcribed. Six themes of analysis were elaborated, one for each support strategy used by the teacher. The results revealed that the strategies employed by the teacher often hampered the child’s orientation and mobility. This was probably the result of a lack of assistance by professionals specialised in Orientation and Mobility, as stipulated in Brazilian legislation.

Molecular basis of Osteoarthritis and aspects of cellular senescence in disease

The aim of this study is to investigate on some molecular mechanisms contributing to the pathogenesis of osteoarthritis (OA) and in particular to the senescence of articular chondrocytes. It is focused on understanding molecular events downstream GSK3β inactivation or dependent on the activity of IKKα, a kinase that does not belong to the phenotype of healthy articular chondrocytes. Moreover, the potential of some nutraceuticals on scavenging ROS thus reducing oxidative stress, DNA damage, and chondrocyte senescence has been evaluated in vitro. The in vitro LiCl-mediated GSK3β inactivation resulted in increased mitochondrial ROS production, that impacted on cellular proliferation, with S-phase transient arrest, increased SA-β gal and PAS staining, cell size and granularity. ROS are also responsible for the of increased expression of two major oxidative lesions, i.e. 1) double strand breaks, tagged by γH2AX, that associates with activation of GADD45β and p21, and 2) 8-oxo-dG adducts, that associate with increased IKKα and MMP-10 expression. The pattern observed in vitro was confirmed on cartilage from OA patients. IKKa dramatically affects the intensity of the DNA damage response induced by oxidative stress (H2O2 exposure) in chondrocytes, as evidenced by silencing strategies. At early time point an higher percentage of γH2AX positive cells and more foci in IKKa-KD cells are observed, but IKKa KD cells proved to almost completely recover after 24 hours respect to their controls. Telomere attrition is also reduced in IKKaKD. Finally MSH6 and MLH1 genes are up-regulated in IKKαKD cells but not in control cells. Hydroxytyrosol and Spermidine have a great ROS scavenging capacity in vitro. Both treatments revert the H2O2 dependent increase of cell death and γH2AX-foci formation and senescence, suggesting the ability of increasing cell homeostasis. These data indicate that nutraceuticals represent a great challenge in OA management, for both therapeutical and preventive purposes.

Localization and mobility-edges in non-interacting fermionic models with disorder

Nel corso degli ultimi decenni la fisica sperimentale ha raggiunto notevoli traguardi nel campo della manipolazione di sistemi di atomi freddi, riaccendendo l'interesse della ricerca su sistemi a lungo studiati teoricamente, ma fino a poco tempo fa impossibili da realizzare sperimentalmente. Questa riaccesa attenzione ha permesso di sfruttare le moderne capacità di calcolo per studiare sistemi quantistici che ancora risultano di difficile realizzazione. In questo contesto si inserisce il rinnovato interesse per i sistemi quantistici monodimensionali caratterizzati dalla presenza di potenziale disordinato. Questi presentano proprietà di trasporto particolari e sotto particolari condizioni sono oggetto di una transizione di localizzazione. La maggior parte degli studi in questo campo rivolgono la loro attenzione a sistemi di particelle fermioniche interagenti. In questo lavoro di tesi analizziamo, invece, sistemi quantistici fermionici non interagenti, mettendo in luce quanto già noto e proponendo strumenti di analisi derivati dallo studio dei sistemi interagenti. In particolare, proponiamo un'analisi statistica dei livelli energetici e poniamo le basi per futuri studi a riguardo.

MRI of hip osteoarthritis and implications for surgery

Osteoarthritis of the hip joint is caused by a combination of intrinsic factors and extrinsic factors. Different surgical techniques are being performed to delay or halt osteoarthritis. Success of salvage procedures of the hip depends on the existing cartilage and joint damage before surgery; the likelihood of therapy failure rises with advanced osteoarthritis. For imaging of intra-articular hip pathology, MR imaging represents the best technique because of its ability to directly visualize cartilage, superior soft tissue contrast, and the prospect of multidimensional imaging. This article gives an overview on the standard MR imaging techniques used for diagnosis of hip osteoarthritis and their implications for surgery.