Impact of subjective and objective neighbourhood characteristics and individual socioeconomic position on allostatic load: A cross-sectional analysis of an all-age UK household panel study

Research suggests that individuals living in more disadvantaged neighbourhoods experience higher levels of stress but this has generally been based on self-reported stress. We used survey-based neighbourhood quality indicators and biomarker data from Understanding Society, linked to census and crime statistics to explore associations of allostatic load (AL), an objective biomarker-based measure of cumulative stress, with subjective and objective neighbourhood characteristics. Analyses of 6887 respondents living in England show greater AL among those living in more disadvantaged areas, with objective measure associations stronger than subjective. Neighbourhood inequalities in AL were lower among respondents with higher individual SEP. These results suggest that individual-level SEP mitigates against the impact of negative, particularly objective, neighbourhood characteristics. Policies to reduce health inequalities should consider both individual and neighbourhood circumstances.     

Learning theories and principles in surgical education and technical learning

What is important to think about in surgical education and technical skills training? Technical skills training is grounded in social cognitive theory and the concepts of modeling and self-efficacy. Cognitive and nontechnical learning is critical to supplement the overall proficiency of the surgical learner in performing an operation. Technical learning is cemented by deliberate practice and there is benefit to productive struggle and failure. External cognitive load should be minimized to maximized operative skills advancement.     

Dietary fat intake and metabolic syndrome in adults: A systematic review

Background and aimsThe metabolic syndrome (MetS) is a cluster of coexisting cardiovascular risk factors. The role of specific dietary fats was reemphasized by dietary recommendations. This systematic review aims to assess evidence for the effect of dietary fat intake on MetS occurrence and reversion in adults.Methods and ResultsThe MEDLINE database was used to search the existing literature. We included observational studies that analyzed dietary fat intake in adults with MetS and clinical trials that compared the effects of different dietary fat diets on MetS and/or its components. Thirty articles were selected (14 observational and 16 clinical trials), and we included information of dietary fat and fatty acids as well as MetS, body mass index, cholesterol, hypertension, and diabetes in adults. SFA intake was found to be positively associated with MetS components. Most of the observational reviewed studies found beneficial associations between MUFA and PUFA (including n-3 and n-6 subtypes) intake and MetS components. Clinical trials also supported the benefits of MUFA- or PUFA-enriched diets (including low-fat diets) in reducing MetS.ConclusionsThe effects of dietary SFAs on MetS will be influenced by other specific nutrients. Replacement of SFA by MUFA and PUFA has been associated with a decrease in MetS. Dietary recommendations should emphasize on different qualities of fat intake, not only to reduce total fat intake, to obtain health benefits in adults.     

Effects of anteriorly-loaded treadmill walking on dynamic gait stability in young adults

BackgroundAnteriorly-loaded walking is common in many occupations and may increase fall risk. Dynamic gait stability, defined by the Feasible Stability Region (FSR) theory, quantifies the kinematic relationship between the body’s center of mass (COM) and base of support (BOS). FSR-based dynamic gait stability has been used to evaluate the fall risk.Research questionHow does front load carriage affect dynamic gait stability, step length, and trunk angle among young adults during treadmill walking?MethodsIn this between-subject design study, 30 healthy young adults were evenly randomized into three load groups (0%, 10%, or 20% of body weight). Participants carried their assigned load while walking on a treadmill at a speed of 1.2 m/s. Body kinematics were collected during treadmill walking. Dynamic gait stability (the primary variable) was calculated for two gait events: touchdown and liftoff. Step length and trunk angle were measured as secondary variables. One-way analysis of variance was conducted to detect any group-related differences for all variables. Post-hoc analysis with Bonferroni correction was performed when main group differences were found.ResultsNo significant differences but medium to large effect sizes were found between groups for dynamic gait stability at touchdown (p = 0.194, η² = 0.114) and liftoff (p = 0.122, η² = 0.139). Trunk angle significantly increased (indicating backward lean) with the front load at touchdown (p < 0.001, η² = 0.648) and liftoff (p < 0.001, η² = 0.543). No significant between-group difference was found related to the step length (p = 0.344, η² = 0.076).SignificanceCarrying a front load during walking significantly alters the trunk orientation and may change the COM-BOS kinematic relationship and, therefore, fall risk. The findings could inform the design of future studies focusing on the impact of anterior load carriage on fall risk during different locomotion.     

负荷渐增式训练对老年小鼠骨骼肌卫星细胞AMPK磷酸化的影响

目的 探讨负荷渐增式训练对老年小鼠骨骼肌卫星细胞腺苷酸活化蛋白激酶（AMP-activated protein kinase，AMPK）磷酸化的影响。方法 实验小鼠分为 3 组：青年对照组（YC组，n=12）、老年对照组（OC组，n=12）与老年运动组（OT组，n=12）。OT组进行负荷渐增式训练，流式细胞分选技术分离CD45-/CD31-/Sca1-/VCAM(CD106)+细胞群体，分选细胞通过desmin、Myod肌原性染色以及成肌分化诱导培养进行肌卫星细胞鉴定，免疫组化结合Western blotting方法检测肌卫星细胞p-AMPK水平。结果 YC组骨骼肌卫星细胞AMPK及p-AMPK表达水平显著高于OC组（P<0.05）；OT组与OC组AMPK表达无明显变化（Ｐ>0.05），而OT组p-AMPK表达水平显著高于OC组（P<0.05）。结论 负荷渐增式训练可促进老年小鼠骨骼肌卫星细胞AMPK磷酸化，改善老年小鼠骨骼肌能量代谢。     

The association of psychiatric medication use with adherence in patients with HIV

Over two million new cases of HIV infection will occur annually, worldwide. Triple drug anti-retroviral therapy (ART) decreases the viral load in patients with HIV, helping to stop progression of HIV infection to AIDs. Our study assessed how pharmacologic treatment for mental health issues affects medication adherence and viral load in patients with HIV. We conducted a retrospective chart review of 163 patients with HIV who had at least 2 visits at the HIV-clinic at Ascension St. John Hospital. Data were collected on demographics, medications, CD4 counts and viral loads. Data were analyzed using Student’s t-test, the χ² test, the Mann–Whitney U test and logistic regression. “Poor Compliance” was defined as at least 2 consecutive visits with a CD4 count <200?µL and/or with viral load ≥100?IU/ml. Patients taking antidepressants were less likely to have poor compliance than those not on anti-depressants (6.3% vs. 22.3%, p?=?0.04). A similar association was found for patients taking any psychiatric drug (7.0% vs. 23.5%, p?=?0.02). On multivariable analysis, the odds of poor compliance were 6.3 times higher in patients who stopped HIV therapy for greater than one week between visits (p?=?0.004) and 3.6 times lower in patients taking any psychiatric medication (p?=?0.05).