Static load bearing exercises during rehabilitation of individuals with transfemoral amputation fitted with osseointegrated implant: Kinetic analysis

The desire to solve problems caused by socket prostheses in transfemoral amputees and the acquired success of osseointegration in the dental application has led to the introduction of osseointegration in the orthopedic surgery. Since its first introduction in 1990 in Gothenburg Sweden the osseointegrated (OI) orthopedic fixation has proven several benefits[1]. The surgery consists of two surgical procedures followed by a lengthy rehabilitation program. The rehabilitation program after an OI implant includes a specific training period with a short training prosthesis. Since mechanical loading is considered to be one of the key factors that influence bone mass and the osseointegration of bone-anchored implants, the rehabilitation program will also need to include some form of load bearing exercises (LBE). To date there are two frequently used commercially available human implants. We can find proof in the literature that load bearing exercises are performed by patients with both types of OI implants. We refer to two articles, a first one written by Dr. Aschoff and all and published in 2010 in the Journal of Bone and Joint Surgery.[2] The second one presented by Hagberg et al in 2009 gives a very thorough description of the rehabilitation program of TFA fitted with an OPRA implant. The progression of the load however is determined individually according to the residual skeleton’s quality, pain level and body weight of the participant.[1] Patients are using a classical bathroom weighing scale to control the load on the implant during the course of their rehabilitation. The bathroom scale is an affordable and easy-to-use device but it has some important shortcomings. The scale provides instantaneous feedback to the patient only on the magnitude of the vertical component of the applied force. The forces and moments applied along and around the three axes of the implant are unknown. Although there are different ways to assess the load on the implant for instance through inverse dynamics in a motion analysis laboratory [3-6] this assessment is challenging. A recent proof- of-concept study by Frossard et al (2009) showed that the shortcomings of the weighing scale can be overcome by a portable kinetic system based on a commercial transducer[7].

Screening midlife women for sleep problems: Why, how, and who should get a referral?

Advancements in sleep medicine have been escalating ever since research began appearing in the 1950s. As with most early clinical trials, women were excluded from participation. Even if researchers included women or addressed sex differences by age, reproductive stage was seldom considered. Recently, there has been an exponential increase in research on sleep in midlife and older women. This Practice Pearl briefly reviews the importance of adequate sleep, clinical assessment for sleep disorders, and guidelines for practice.

Comparison of Body Composition Assessment Methods in Breast Cancer Survivors

Purpose/Objectives: To examine and compare the reliability of four body composition methods commonly used in assessing breast cancer survivors. Design: Cross-sectional. Setting: A rehabilitation facility at a university-based comprehensive cancer center in the southeastern United States. Sample: 14 breast cancer survivors aged 40-71 years. Methods: Body fat (BF) percentage was estimated via bioelectric impedance analysis (BIA), air displacement plethysmography (ADP), and skinfold thickness (SKF) using both three- and seven-site algorithms, where reliability of the methods was evaluated by conducting two tests for each method (test 1 and test 2), one immediately after the other. An analysis of variance was used to compare the results of BF percentage among the four methods. Intraclass correlation coefficient (ICC) was used to test the reliability of each method. Main Research Variable: BF percentage. Findings: Significant differences in BF percentage were observed between BIA and all other methods (three-site SKF, p < 0.001; seven-site SKF, p < 0.001; ADP, p = 0.002). No significant differences (p > 0.05) in BF percentage between three-site SKF, seven-site SKF, and ADP were observed. ICCs between test 1 and test 2 for each method were BIA = 1, ADP = 0.98, three-site SKF = 0.99, and seven-site SKF = 0.94. Conclusions: ADP and both SKF methods produce similar estimates of BF percentage in all participants, whereas BIA overestimated BF percentage relative to the other measures. Caution is recommended when using BIA as the body composition method for breast cancer survivors who have completed treatment but are still undergoing adjuvant hormonal therapy. Implications for Nursing: Measurements of body composition can be implemented very easily as part of usual care and should serve as an objective outcome measure for interventions designed to promote healthy behaviors among breast cancer survivors. - See more at: https://onf.ons.org/onf/38/4/comparison-body-composition-assessment-methods-breast-cancer-survivors#sthash.5djfTS1Q.dpuf

Unlearning leadership in the conceptual age

"We live in times in which unlearning has become as important as learning. Dan Pink has called these times the Conceptual Age,i to distinguish them from the Knowledge/Information Age in which many of us were born and educated. Before the current Conceptual Age, the core business of learning was the routine accessing of information to solve routine problems, so there was real value in retaining and reusing the templates taught to us at schools and universities. What is different about the Conceptual Age is that it is characterised by new cultural forms and modes of consumption that require us to unlearn our Knowledge/Information Age habits to live well in our less predictable social world. The ‘correct’ way to write, for example, is no longer ‘correct’ if communicating by hypertext rather than by essay or letter. And who would bother with an essay or a letter or indeed a pen these days? Whether or not we agree that the Conceptual Age, amounts to the first real generation gap since rock and roll, as Ken Robinson claims,ii it certainly makes unique demands of educators, just as it makes unique demands of the systems, strategies and sustainability of organisations. Foremost among these demands, according to innovation analyst Charlie Leadbeater,iii is to unlearn the idea that we are becoming a more knowledgeable society with each new generation. If knowing means being intimately familiar with the knowledge embedded in the technologies we use in our daily lives, then, Leadbeater says, we have never been more ignorant.iv He reminds us that our great grandparents had an intimate knowledge of the technologies around them, and had no problem with getting the butter churn to work or preventing the lamp from smoking. Few of us would know what to do if our mobile phones stopped functioning, just as few of us know what is ‘underneath’ or ‘behind’ the keys of our laptops. Nor, indeed, do many of us want to know. But this means that we are all very quickly reduced to the quill and the lamp if we lose our power sources or if our machines cease to function. This makes us much more vulnerable – as well as much more ignorant in relative terms – than our predecessors."

Ubuntu and business ethics: Problems, perspectives and prospects

The African philosophy of Ubuntu is typically characterised as a communitarian philosophy that emphasises virtues such as compassion, tolerance and harmony. In recent years there has been growing interest in this philosophy, and in how it can be applied to a variety of disciplines and issues. Several authors have provided useful introductions of Ubuntu in the field of business ethics and suggested theoretical ways in which it could be applied. The purpose of this paper is to extend this discussion by providing a more critical analysis of Ubuntu and business ethics with the aim of clarifying the role that Ubuntu can play, and providing guidance for further research in this area. The analysis consists of three sections. In the first, certain problems are identified within the existing literature. This is followed by a consideration of alternative perspectives and interpretations of Ubuntu. The last section, following from the first two, identifies specific areas requiring further research, both empirical and non-empirical, as well as ways in which Ubuntu could be fruitfully applied.

Problems with the coronial determination of ‘suicide’

After over 100 years of constant dissatisfaction with the accuracy of suicide data, this paper suggests that the problem may actually lie with the category of suicide itself. In almost all previous research, ‘suicide’ is taken to be a self-evidently valid category of death, not an object of study in its own right. Instead, the focus in this paper is upon the presupposition that how a social fact like suicide is counted depends upon norms for its governmental regulation, leading to a reciprocal relationship between social norms and statistical norms. Since this relationship is centred almost entirely in the coroner’s office, this paper examines governmental, definitional and categorisational issues relating to how coroners reach findings of suicide. The intention of this paper is to contribute to international debates over how suicide can best be conceptualised and adjudged.

Challenges in embedding numeracy throughout the curriculum in three Queensland secondary schools

The new Australian Curriculum and national standardised testing have placed the teaching of numeracy across the curriculum at the forefront of what Australian schools must do. However, it has been left to schools to determine how they do this. Although there is a growing body of literature giving examples of pedagogies that embed numeracy in various learning areas, there are few studies of cross-curricular numeracy from the management perspective. This paper responds to the research question: How do selected Queensland secondary schools interpret and apply the Australian Curriculum requirement to embed numeracy throughout the curriculum? A multiple case study design was used to investigate the actions of the senior managers and mathematics teachers in three large secondary schools located in outer Brisbane. The numeracy practices in the three schools were interpreted from asocial constructivist perspective. The study found that in each school key managers had differing constructions of numeracy that led to confusion in administrative practices, policy development and leadership. The lack of coordinated cross-curricular action in numeracy in all three schools points to the difficulty that arises when teachers do not share the cross-curricular vision of numeracy present in the Australian Curriculum. The managers identified teachers’ commitment, understanding, or skills in relation to numeracy as significant barriers to the successful implementation of numeracy in their school. Adoption of the Australian Curriculum expectation of embedding numeracy across the curriculum will require school managers to explicitly commit to initiatives that require persistence,time and, most importantly, money.

Lewis's medical-surgical nursing: Assessment and management of clinical problems [ANZ Edition, 4th Ed.]

"Using the nursing process as a framework for practice, the fourth edition has been extensively revised to reflect the rapid changing nature of nursing practice and the increasing focus on key nursing care priorities. Building on the strengths of the third Australian and New Zealand edition and incorporating relevant global nursing research and practice from the prominent US title Medical-Surgical Nursing, 9Th Edition, Lewis’s Medical-Surgical Nursing, 4th Edition is an essential resource for students seeking to understand the role of the professional nurse in the contemporary health environment."--Publisher website

Two-dimensional bow and stern flows in a finite-depth fluid with constant vorticity

This thesis is concerned with two-dimensional free surface flows past semi-infinite surface-piercing bodies in a fluid of finite-depth. Throughout the study, it is assumed that the fluid in question is incompressible, and that the effects of viscosity and surface tension are negligible. The problems considered are physically important, since they can be used to model the flow of water near the bow or stern of a wide, blunt ship. Alternatively, the solutions can be interpreted as describing the flow into, or out of, a horizontal slot. In the past, all research conducted on this topic has been dedicated to the situation where the flow is irrotational. The results from such studies are extended here, by allowing the fluid to have constant vorticity throughout the flow domain. In addition, new results for irrotational flow are also presented. When studying the flow of a fluid past a surface-piercing body, it is important to stipulate in advance the nature of the free surface as it intersects the body. Three different possibilities are considered in this thesis. In the first of these possibilities, it is assumed that the free surface rises up and meets the body at a stagnation point. For this configuration, the nonlinear problem is solved numerically with the use of a boundary integral method in the physical plane. Here the semi-infinite body is assumed to be rectangular in shape, with a rounded corner. Supercritical solutions which satisfy the radiation condition are found for various values of the Froude number and the dimensionless vorticity. Subcritical solutions are also found; however these solutions violate the radiation condition and are characterised by a train of waves upstream. In the limit that the height of the body above the horizontal bottom vanishes, the flow approaches that due to a submerged line sink in a $90^\circ$ corner. This limiting problem is also examined as a special case. The second configuration considered in this thesis involves the free surface attaching smoothly to the front face of the rectangular shaped body. For this configuration, nonlinear solutions are computed using a similar numerical scheme to that used in the stagnant attachment case. It is found that these solution exist for all supercritical Froude numbers. The related problem of the cusp-like flow due to a submerged sink in a corner is also considered. Finally, the flow of a fluid emerging from beneath a semi-infinite flat plate is examined. Here the free surface is assumed to detach from the trailing edge of the plate horizontally. A linear problem is formulated under the assumption that the elevation of the plate is close to the undisturbed free surface level. This problem is solved exactly using the Wiener-Hopf technique, and subcritical solutions are found which are characterised by a train of sinusoidal waves in the far field. The nonlinear problem is also considered. Exact relations between certain parameters for supercritical flow are derived using conservation of mass and momentum arguments, and these are confirmed numerically. Nonlinear subcritical solutions are computed, and the results are compared to those predicted by the linear theory.

Weight-related risk perception among healthy and overweight pregnant women: A cross-sectional study

Objective The objective of this study was to evaluate weight-related risk perception in early pregnancy and to compare this perception between women commencing pregnancy healthy weight and overweight. Study design Pregnant women (n=664) aged 29±5 (mean±s.d.) years were recruited from a metropolitan teaching hospital in Australia. A self-administered questionnaire was completed at around 16 weeks of gestation. Height measured at baseline and self-reported pre-pregnancy weight were used to calculate body mass index. Cross-sectional analysis was conducted. Differences between groups were assessed using chi-squared tests for categorical variables and t-tests or Mann–Whitney U tests for continuous variables depending on distribution. Result Excess gestational weight gain (GWG) during pregnancy was more important in leading to health problems for women or their child compared with pre-pregnancy weight. Personal risk perception for complications was low for all women, although overweight women had slightly higher scores than healthy-weight women (2.4±1.0 vs 2.9±1.0; P<0.001). All women perceived their risk for complications to be below that of an average pregnant woman. Conclusion Women should be informed of the risk associated with their pre-pregnancy weight (in the case of maternal overweight) and excess GWG. If efforts to raise risk awareness are to result in preventative action, this information needs to be accompanied by advice and appropriate support on how to reduce risk.

Predicting people’s intention to donate their body to medical science and research

Predictors of people’s intention to register with a body bequest program for donating their deceased body to medical science and research were examined using standard theory of planned behavior (TPB) predictors (attitude, subjective norm, perceived behavioral control) and adding moral norm, altruism, and knowledge. Australian students (N = 221) at a university with a recently established body bequest program completed measures of the TPB’s underlying beliefs (behavioral, normative, and control beliefs) and standard and extended TPB predictors, with a sub-sample reporting their registration-related behavior 2 months later. The standard TPB accounted for 43.6%, and the extended predictors an additional 15.1% of variance in intention. The significant predictors were attitude, subjective norm, and moral norm, partially supporting an extended TPB in understanding people’s body donation intentions. Further, important underlying beliefs can inform strategies to target prospective donors.

A developmental cascade model of behavioral sleep problems and emotional and attentional self-regulation across early childhood

This paper documents the longitudinal and reciprocal relations among behavioral sleep problems, emotional and attentional self-regulation in a population sample of 4109 children participating in the Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) – Infant Cohort. Maternal reports of children’s sleep problems and self-regulation were collected at five time points from infancy to 8-9 years of age. Longitudinal structural equation modeling supported a developmental cascade model in which sleep problems have a persistent negative effect on emotional regulation, which in turn contributes to ongoing sleep problems and poorer attentional regulation in children over time. Findings suggest that sleep behaviors are a key target for interventions that aim to improve children’s self-regulatory capacities.

Stroke: A brain attack!

Brain cells control everything we do - from speaking to walking to breathing. The brain needs a steady supply of blood and oxygen to function properly. Without this vital steady supply of blood, brain cells don't get enough nutrients and oxygen to do their job, and a stroke or 'brain attack' occurs. The human brain is divided into regions that control various motor (movement) and sensory (the senses) functions. Damage from stroke to a specific region may affect the functions it controls. This causes symptoms such as paralysis (loss of movement), difficulty speaking, or loss of coordination. The left side of the brain controls motor and sensory functions on the right side of the body. The left side is also responsible for scientific functions, understanding written and spoken language, number skills and reasoning. The right side of the brain controls motor and sensory functions on the left side of the body. It also controls artistic functions, such as music, art awareness, and insight. If an artery inside the brain or leading to the brain becomes temporarily blocked, the flow of blood to an area of the brain slows or stops. The lack of blood can cause temporary symptoms such as weakness, numbness, problems with speech, dizziness, or loss of vision.

Who owns your body? Patricia Piccinini and the future of bioethics

This article analyses some popular cultural representations of biotechnology, especially the artistic work of the Australian artist Patricia Piccinini to reflect on the role of law, technology and ethics in relation to bodily material. Her view that "with creation...comes an obligation to care for the result", so evident in her poignant pictures, is a sober reminder to us of our responsibilities in regulating new technologies.

Influence of habitual physical activity on gastric emptying in healthy males and relationships with body composition and energy expenditure

Although a number of studies have examined the role of gastric emptying (GE) in obesity, the influences of habitual physical activity level, body composition and energy expenditure (EE) on GE have received very little consideration. In this study, we have compared GE in active and inactive males, and we have characterised relationships with body composition (fat and fat free mass) and EE. Forty-four males (Active: n=22, Inactive: n=22; range BMI 21-36kg/m2; range percent fat mass 9-42%) were studied, with GE of a standardised (1676 kJ) pancake meal being assessed by 13C-octanoic acid breath test, body composition by air displacement plethysmography, resting metabolic rate (RMR) by indirect calorimetry and activity EE (AEE) by accelerometry. Results showed that GE was faster in active compared to inactive males (mean ±SD half time (t1/2): Active: 157±18 and Inactive: 179±21 min, p<0.001). When data from both groups were pooled, GE t1/2 was associated with percent fat mass (r=0.39, p<0.01) and AEE (r =-0.46, p<0.01). After controlling for habitual physical activity status, the association between AEE and GE remained, but not that for percent fat mass and GE. BMI and RMR were not associated with GE. In summary, faster GE is considered to be a marker of a habitually active lifestyle in males, and is associated with a higher AEE and lower percent fat mass. The possibility that GE contributes to a gross physiological regulation (or dysregulation) of food intake with physical activity level deserves further investigation.