Obesity and pronated foot type may increase the risk of chronic plantar heel pain : a matched case-control study

Background : Chronic plantar heel pain (CPHP) is one of the most common musculoskeletal disorders of the foot, yet its aetiology is poorly understood. The purpose of this study was to examine the association between CPHP and a number of commonly hypothesised causative factors.

Methods : Eighty participants with CPHP (33 males, 47 females, mean age 52.3 years, S.D. 11.7) were matched by age (± 2 years) and sex to 80 control participants (33 males, 47 females, mean age 51.9 years, S.D. 11.8). The two groups were then compared on body mass index (BMI), foot posture as measured by the Foot Posture Index (FPI), ankle dorsiflexion range of motion (ROM) as measured by the Dorsiflexion Lunge Test, occupational lower limb stress using the Occupational Rating Scale and calf endurance using the Standing Heel Rise Test.

Results : Univariate analysis demonstrated that the CPHP group had significantly greater BMI (29.8 ± 5.4 kg/m2 vs. 27.5 ± 4.9 kg/m2; P < 0.01), a more pronated foot posture (FPI score 2.4 ± 3.3 vs. 1.1 ± 2.3; P < 0.01) and greater ankle dorsiflexion ROM (45.1 ± 7.1° vs. 40.5 ± 6.6°; P < 0.01) than the control group. No difference was identified between the groups for calf endurance or time spent sitting, standing, walking on uneven ground, squatting, climbing or lifting. Multivariate logistic regression revealed that those with CPHP were more likely to be obese (BMI ≥ 30 kg/m2) (OR 2.9, 95% CI 1.4 – 6.1, P < 0.01) and to have a pronated foot posture (FPI ≥ 4) (OR 3.7, 95% CI 1.6 – 8.7, P < 0.01).

Conclusion : Obesity and pronated foot posture are associated with CPHP and may be risk factors for the development of the condition. Decreased ankle dorsiflexion, calf endurance and occupational lower limb stress may not play a role in CPHP.

Foot complications in Type 2 diabetes : an Australian population-based study

Aims To determine the prevalence and risk factors for neuropathy and peripheral vascular disease (PVD) in the Australian diabetic population and identify those at high risk of foot ulceration.

Methods The Australian Diabetes Obesity and Lifestyle study included 11 247 adults aged ≥ 25 years in 42 randomly selected areas of Australia. Neuropathy and PVD were assessed in participants identified as having diabetes (based on self report and oral glucose tolerance test), impaired fasting glucose, impaired glucose tolerance and in a random sample with normal glucose tolerance (total n = 2436).

Results The prevalence of peripheral neuropathy was 13.1% in those with known diabetes (KDM) and 7.1% in those with newly diagnosed (NDM). The prevalence of PVD was 13.9% in KDM and 6.9% in NDM. Of those with diabetes, 19.6% were at risk of foot ulceration. Independent risk factors for peripheral neuropathy were diabetes duration (odds ratio (95% CI) 1.73 (1.33–2.28) per 10 years), height (1.42 (1.08–1.88) per 10 cm), age (2.57 (1.94–3.40) per 10 years) and uric acid (1.59 (1.21–2.09) per 0.1 mmol/l). Risk factors for PVD were diabetes duration (1.64 (1.25–2.16) per 10 years), age (2.45 (1.86–3.22) per 10 years), smoking (2.07 (1.00–4.28)), uric acid (1.03 (1.00–1.06) per 0.1 mmol/l) and urinary albumin/creatinine ratio (1.11 (1.01–1.21) per 1 mg/mmol).

Conclusions The prevalence of neuropathy and PVD was lower in this population than has been reported in other populations. This may reflect differences in sampling methods between community and hospital-based populations. Nevertheless, a substantial proportion of the diabetic population had risk factors for foot ulceration.

HOMA insulin sensitivity index and the risk of all-cause mortality and cardiovascular disease events in the general population : the Australian diabetes, obesity and lifestyle study (AusDiab) study

Aims/hypothesis We assessed whether the relationships between insulin sensitivity and all-cause mortality as well as fatal or non-fatal cardiovascular disease (CVD) events are independent of elevated blood glucose, high blood pressure, dyslipidaemia and body composition in individuals without diagnosed diabetes.
Methods Between 1999 and 2000, baseline fasting insulin, glucose and lipids, 2 h plasma glucose, HbA1c, anthropometrics, blood pressure, medication use, smoking and history of CVD were collected from 8,533 adults aged >35 years from the population-based Australian Diabetes, Obesity and Lifestyle study. Insulin sensitivity was estimated by HOMA of insulin sensitivity (HOMA-%S). Deaths and fatal or non-fatal CVD events were ascertained through linkage to the National Death Index and medical records adjudication.
Results After a median of 5.0 years there were 277 deaths and 225 CVD events. HOMA-%S was not associated with all-cause mortality. Compared with the most insulin-sensitive quintile, the combined fatal or non-fatal CVD HR (95% CI) for quintiles of decreasing HOMA-%S were 1.1 (0.6–1.9), 1.4 (0.9–2.3), 1.6 (1.0–2.5) and 2.0 (1.3–3.1), adjusting for age and sex. Smoking, CVD history, hypertension, lipid-lowering medication, total cholesterol and waist-to-hip ratio moderately attenuated this relationship. However, the association was rendered non-significant by adding HDL. Fasting plasma glucose, but not HOMA-%S significantly improved the prediction of CVD, beyond that seen with other risk factors.
Conclusions/interpretation In this cohort, HOMA-%S showed no association with all-cause mortality and only a modest association with CVD events, largely explained by its association with HDL. Fasting plasma glucose was a better predictor of CVD than HOMA-%S.

Listed property trusts and downside systematic risk sensitivity

Purpose: This paper aims to identify and examine the determinants of downside systematic risk in Australian listed property trusts (LPTs).

Design/methodology/approach: Capital asset pricing model (CAPM) and lower partial moment-CAPM (LPM-CAPM) are employed to compute both systematic risk and downside systematic risk. The methodology of Patel and Olsen and Chaudhry et al. is adopted to examine the determinants of systematic risk and downside systematic risk.

Findings: The results confirm that systematic risk and downside systematic risk can be individually identified. There is little evidence to support the existence of linkages between systematic risk in Australian LPTs and financial/management structure determinants. On the other hand, downside systematic risk is directly related to the leverage/management structure of a LPT. The results are also robust after controlling for the LPTs' investment characteristics and varying target rates of return.

Practical implications: Investors and real estate analysts should conscious with the higher returns from high leverage and internally managed LPTs. Although there is no evidence that these higher returns are related to higher systematic risk, there could be the compensation for higher downside systematic risk.

Originality/value: This study provides invaluable insights into the management of real estate risk in Australian LPTs with implications for REITs in other countries. Unlike previous studies of systematic risk in REITs or LPTs, this is the first study to assess downside systematic risk and explore the determinants of downside systematic risk in LPTs.

Information-based regulation of high-velocity foot-targeting tasks

Judging time-to-contact with a target is an important criterion for avoiding harm in everyday walking and running tasks, and maximizing performance in high-velocity sporting tasks. The information-based regulation of step length and duration during target-directed locomotion was examined in relation to gait mode, approach velocity, target task, expertise, and sporting performance during a series of four experiments. The first three experiments examined novice performers (Each n=12, 6 males, 6 females), whilst the last experiment examined expert gymnasts (n=5). Two reference strips with alternating 50cm black and white intervals were placed on either side of the approach strip for all of the experiments. One 50Hz-panning video camera filmed the approach from an elevated position. In Experiment 4, two stationary 250Hz cameras filmed the post-flight performance of the gymnastic vaults and, in addition, two qualified judges provided a performance score for each vaulting trial. The panning video footage in each experiment was digitized to deduce the gait characteristics. In Experiment 4, the high-speed video footage was analyzed three-dimensionally to obtain the performance measures such as post-flight height. The utilization of visual stimulus in target-directed locomotion is affected by the observer's state of motion as characterized by the mode of locomotion and also often the speed of locomotion. In addition, experience plays an important role in the capacity of the observer to utilize visual stimulus to control the muscular action of locomotion when either maintaining or adjusting the step mechanics. The characteristics of the terrain and the target also affect the observer's movement. Visual regulation of step length decreases at higher approach speeds in novice performers, where as expert performers are capable of increasing visual regulation at higher approach speeds. Conservatism in final foot placement by female participants accounts for the observed increase in distance from the critical boundary of the obstacle relative to toe placement. Behavioural effects of gender thus affect the control of final foot placement in obstacle-directed locomotion. The visual control of braking in target-directed locomotion is described by a tau-dot of-0.54. When tau-dot is below -0.54 a hard collision with the obstacle will occur, however, when tau-dot is above -0.54, a soft collision with the target will occur. It is suggested that the tau-dot margin defining the control of braking reveals the braking capacity of the system. In the target-directed locomotion examined a tau-dot greater than -0.70 would possibly exceed the braking capacity of the system, thus, leading to injury if performed. The approach towards the take-off board and vaulting horse in gymnastics is an example of target-directed locomotion in sport. Increased visual regulation of the timing and length of each step is a requirement for a fast running approach, a fundamental building block for the execution of complex vaults in gymnastics. The successful performance of complex vaults in gymnastics leads towards a higher judge's score. Future research suggestions include an investigation of visual regulation of step length in curved target-directed locomotion.

The effect of strain rate on the deformation mechanisms and the strain rate sensitivity of an ultra-fine-grained Al alloy

An ultra-fine-grained Al alloy was subjected to compression tests at different strain rates. The strain rate sensitivity of the flow stress was estimated. A strong effect of the baseline strain rate on the mechanisms of plastic deformation was found. It is suggested that a decrease of strain rate results in activation of micro shear banding due to grain boundary sliding. A connection between the strain rate, strain rate sensitivity, and the prevalent deformation mechanism was established.

Smoking and drinking behaviours : the role of Reinforcement Sensitivity Theory

This thesis examines the predictions of Jeffrey Gray's Reinforcement Sensitivity Theory in the development of smoking and hazardous drinking behaviours in young women. Impulsivity was found to significantly predict alcohol use and young women who smoked and drank at hazardous levels were significantly more impulsive than hazardous drinkers.

Reinforcement sensitivity theory : a paradigm for understanding the motivational processes underlying alcohol use

Provides an examination of the processes which motivate individuals to drink alcohol. It was found that heavier drinkers are highly sensitive to reward yet more likely to experience negative affect, both generally, and in response to alcohol-related cues. Based on these findings a model focusing on the links between personality, mood and craving for alcohol was developed.

Sensitivity to motivational cues in attention-deficit / hyperactivity disorder

This thesis examined a prediction of Reinforcement Sensitivity Theory regarding the association between personality traits and motivated behaviour and, whether reward-and-punishment sensitivity is associated with Attention-deficit / Hyperactivity disorder (ADHD). Results supported the predicted association between personality and motivated behaviour, but not the predicted association between reward-and-punishment sensitivity and ADHD.

Disordered eating and drinking behaviours : the role of sensitivity to reward and punishment

Examines whether the personality traits of sensitivity to reward and punishment as defined by Jeffrey Gray contributed to the prediction of disordered eating and hazardous alcohol use. Studies were conducted in both subclinical and clinical populations. Heightened sensitivity to reward contributed to the prediction of hazardous alcohol use and heightened sensitivity to punishment contributed to the prediction of disordered eating in women. Women with comorbid bulimia and alcohol dependence were more behaviourally sensitive to reward than normal controls.

Development and evaluation of an ELISA for the detection and 3D antibodies to foot and mouth disease virus

A group specific ELISA (enzyme-linked immunosorbent assay) was developed to detect virus infection associated antibodies in the serum of animals infected with any serotype of foot and mouth disease virus. The assay was developed from non-infectious sources, and is therefore suitable for use in countries where FMDV is exotic.