Comparison of changes in abdominal muscle thickness between standing and crook lying during active abdominal hollowing using ultrasound imaging

To determine if transversus abdominis (TrA) demonstrates a greater increase in thickness on lower abdominal hollowing (LAH) in standing compared to crook lying.Muscle thickness measurements of TrA, addition of internal obliques (IO) and external obliques (EO) were measured using ultrasound imaging at rest and during LAH on 28 healthy controls (14 female, 14 male) in crook lying and standing.TrA demonstrated greater thickness changes on LAH in standing (+0.88 mm ± 0.12 mm). IO and EO demonstrated greater thickness changes on LAH in crook lying (+0.59 mm ± 0.08 mm and ?0.87 mm ± 0.12 mm, respectively). These differences were all significant (p < 0.001). Increased resting thickness was noted in standing in TrA (20.7%), IO (10.3%) and EO (1.2%). This increase was only significantly different between TrA and EO (P = 0.004).TrA showed significantly greater increases in thickness on LAH in standing compared to crook lying, and with greater specificity in relation to IO and maybe EO. If muscle thickness can be an indicator of muscle function or activity, then this suggests that TrA rehabilitation should be facilitated in positions of greater function, such as standing.     

Inflammatory arthritis in children with osteochondrodysplasias

Osteochondrodysplasias are a heterogeneous group of genetic skeletal dysplasias. Patients with these diseases commonly develop an early degenerative arthritis or osteoarthritis. Occasional observations of inflammatory arthritis have been made in this population but such observations are based on clinical grounds alone without confirmatory imaging studies. Four patients followed up in a paediatric rheumatology clinic with three different skeletal dysplasias, who had both clinical and radiological evidence of an inflammatory arthritis and coexistent degenerative arthritis, are described.     

Dual action ectoparasite vaccine targeting 'exposed' and 'concealed' antigens

Blood-feeding ectoparasites, such as mosquitoes, sandflies and ticks, transmit many disease agents. Their control relies on large-scale, repeated use of chemical pesticides. An alternative, targeted and environmentally friendly approach is to develop anti-ectoparasite vaccines. We describe a vaccine to control ticks that targets an 'exposed' tick saliva antigen and cross-reacts with 'concealed' tick midgut antigens. Ticks feeding on immunised animals induced a cutaneous inflammatory response and increased antibody titer, while engorged ticks died following damage to their midgut. This dual action, acting at the feeding site and in the midgut, offers a self-sustaining strategy for ectoparasite control boosted by natural infestations.     

Becoming a competent clinician: basic competencies in intervention

This article summarizes the results from the Intervention Work Group of the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology. The generic charge presented to the Intervention Work Group was "to address issues related to interventions." The Intervention Work Group identified four competency components of knowledge, skills, and abilities: (a). foundational competencies; (b). intervention planning; (c). intervention implementation; and (d). intervention evaluation competencies. A fifth component that included "practice management" was labeled as "others." Each component is discussed, including competencies that were deemed an essential knowledge, skill, and/or value. A discussion of training for intervention competence and assessing that intervention competence is included. Future directions for the science and practice of psychology in the intervention arena are summarized. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.     

Diabetic retinopathy: protecting the vision of people with diabetes

The aim of this article is to provide an update on the effects, causes and treatment of diabetic retinopathy and to discuss practical ways in which community nurses can help protect people with diabetes from losing their vision and support them if they do.     

Clinicopathological study of the WHO classification in childhood lupus nephritis

Over the past 10 years, at our center, 25 children diagnosed with systemic lupus erythematosus (SLE) have undergone an early renal biopsy; 15 underwent a second biopsy. The objective of this study was to determine whether clinical and laboratory parameters used to evaluate lupus disease activity and nephritis correlated with the WHO class on biopsy. At diagnosis, the presence of proteinuria, hematuria, a lower serum albumin, and the need for blood pressure medication were all associated with a worse class of lupus nephritis (P<0.05). On follow-up biopsy, however, none of these parameters correlated with the WHO class. Thus, it appears that while the WHO classification is useful for categorizing disease at presentation, it may be less useful for the evaluation of disease progression. Other biopsy indices need to be evaluated in serial renal biopsies to better understand the progression of lupus nephritis once treatment has been initiated.