Does the perceived neighborhood reputation contribute to neighborhood differences in social trust and residential wellbeing?

The authors used a mixed methods approach to examine if the reputation of a housing area has bearing on residential wellbeing and social trust in three pairs of socioeconomically contrasting neighborhoods in a Swedish urban municipality. Multilevel logistic regression analyses were performed to examine associations between area reputation and residential wellbeing and social trust, controlling for the random effect of neighborhood and individual level sociodemographic factors. Qualitative data were analyzed to identify mechanisms of how neighborhood reputations were established. The housing area reputation was found to be strongly associated with wellbeing and social trust. The area reputation also seemed to be a determinant of position in the local social structure; residents were found to position themselves in a rank order. The results suggest that area reputation is an important and probably underestimated dimension in the development of residential wellbeing and social trust in housing. © 2010 Wiley Periodicals, Inc.     

The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS): a study protocol for a prospective longitudinal study

Background

Paralympic sport provides sporting opportunities for athletes with a disability, with the Paralympic Games as the main event. Participation in sport is, however, associated with a significant risk for sustaining injuries and illnesses. Our knowledge of sports-related injuries and illnesses in Paralympic sport is very limited and there are no large-scale epidemiological cohort studies. The purpose here is to present a protocol for a prospective longitudinal study: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS).

Methods/design

An argument-based method for investigation of design problems was used to structure the study protocol. The primary requirement of the protocol is to allow prospective studies over time and include exposure to both training and competition. To reflect the complexity of Paralympic sport with athletes’ pre-existing impairments, use of assistive equipment, pain and other and medical issues, it is required that the data collection system is specifically adapted to Paralympic sport. To allow the collection of data, at the same time as there is limited access to coaches and medical personnel, it is advantageous that data can be collected online directly from the athletes. Based on this a self-report athlete monitoring system will be developed, where the athletes can enter data weekly via their mobile phones or lap-tops. Data will be collected from around 100 Swedish Paralympic athletes for approximately 1 year, which will allow us to i) prospectively estimate the annual incidence of sports-related injuries and illnesses and ii) explore risk factors and mechanisms for sustaining sports-related injuries and illnesses based on athlete exposure and training loads.

Discussion

For effective implementation of injury and illness prevention measures, comprehensive epidemiological knowledge is required. This study will be the first prospective longitudinal self-report study of sports-related injuries and illnesses in Paralympic sport over a longer period of time. The results will eventually contribute to the development of evidence-based preventive measures specifically adapted to Paralympic sport in order to provide safe and healthy sport participation. Thereby, the project will be of relevance for Paralympic athletes at all levels and to the Paralympic Movement.

Trial registration

The study is registered at ClinicalTrials.gov (Identifier: NCT02788500; Registration date: 22 May 2016).

     

Intergenerational Cardiovascular Disease Risk Factors Involve Both Maternal and Paternal BMI

OBJECTIVE

To examine the association between parental BMI and offspring cardiovascular disease (CVD) risk factors.

RESEARCH DESIGN AND METHODS

The study comprised 940 children (9.5 ± 0.4 years) and 873 adolescents (15.5 ± 0.5 years). Parental weight and height were reported by the mother and the father, and BMI was calculated. CVD risk factors included total (sum of five skinfolds) and central (waist circumference) body fat, blood pressure, cardiorespiratory fitness, insulin sensitivity, total cholesterol, HDL cholesterol, triglycerides, and fibrinogen.

RESULTS

Maternal and paternal BMI were positively associated with total and central fatness in offspring (P < 0.001). BMIs of both parents were significantly related to fibrinogen levels (P < 0.02), but these associations disappeared when controlling for fatness. There was a positive relationship between maternal and paternal BMI and waist circumference in the offspring regardless of total adiposity and height (P < 0.001). Maternal BMI was negatively associated with offspring cardiorespiratory fitness independently of fatness (P < 0.02). These relationships persisted when overweight descendants were excluded from the analysis. There were no significant associations between parental BMI and the other CVD risk factors.

CONCLUSIONS

Both maternal and paternal BMI increase CVD risk factors of their offspring, characterized by total and central body fat, and higher maternal BMI was associated with poorer cardiorespiratory fitness. Our findings give further support to the concept that adiposity in parents transmits susceptibility to CVD risk to descendants, which is detectable even in the absence of overweight in offspring.Parental obesity substantially increases the risk of obesity in offspring through genetic, biological, or environmental influences (1). The fetal overnutrition hypothesis suggests that maternal obesity and/or gestational diabetes may predispose offspring to increased adiposity in adulthood (2). Human studies showed a greater influence of maternal than paternal BMI on offspring adiposity (3,4). In contrast, others suggested that the contribution of the mother and the father on both prenatal and postnatal programming of intergenerational obesity may be similar according to the genomic imprinting (5).Most of the studies focused on the relationships of maternal and paternal BMI with their offspring BMI provided contradictory results (3,6,7), and only one study compared the association of maternal and paternal BMI with total body fat in the offspring (8). Whether the parental BMI-offspring body fat relationship applies to other established cardiovascular disease (CVD) risk factors remains to be elucidated.Excess adiposity leads to increased CVD risk factors and biological pathway alterations as insulin resistance, dyslipemia, hypertension, systemic inflammation, and low cardiorespiratory fitness (9). Therefore, the parental BMI-offspring CVD risk factor relationship may be influenced by the offspring body composition.The European Youth Heart Study (EYHS) provides an opportunity to better understand the parental-descendant aggregation of CVD factors by controlling for other potential confounding factors that could mediate in this relationship. Therefore, the aim of this study was to determine the association between both maternal and paternal BMI and the offspring CVD risk factors including total and central body fat, cardiorespiratory fitness, insulin sensitivity, blood pressure, blood lipids, and fibrinogen. We also examined the role of offspring adiposity in this relationship.     

Induction of increased cAMP levels in articular chondrocytes blocks matrix metalloproteinase-mediated cartilage degradation, but not aggrecanase-mediated cartilage degradation

OBJECTIVE: Calcitonin has been suggested to have chondroprotective effects. One signaling pathway of calcitonin is via the second messenger cAMP. We undertook this study to investigate whether increased cAMP levels in chondrocytes would be chondroprotective. METHODS: Cartilage degradation was induced in bovine articular cartilage explants by 10 ng/ml oncostatin M (OSM) and 20 ng/ml tumor necrosis factor (TNF). In these cultures, cAMP levels were augmented by treatment with either forskolin (4, 16, or 64 microM) or 3-isobutyl-1-methyl xanthine (IBMX; 4, 16, or 64 microM). Cartilage degradation was assessed by 1) quantification of C-terminal crosslinking telopeptide of type II collagen fragments (CTX-II), 2) matrix metalloproteinase (MMP)-mediated aggrecan degradation by (342)FFGV- G2 assay, 3) aggrecanase-mediated degradation by (374)ARGS-G2 assay, 4) release of sulfated glycosaminoglycans (sGAG) into culture medium, 5) immunohistochemistry with a monoclonal antibody recognizing the CTX-II epitope, and 6) toluidine blue staining of proteoglycans. MMP expression and activity were assessed by gelatin zymography. RESULTS: OSM and TNF induced an 8,000% increase in CTX-II compared with control (P < 0.001). Both forskolin and IBMX dose-dependently inhibited release of CTX-II (P < 0.001). OSM and TNF induced a 6-fold increase in (342)FFGV-G2, which was abrogated by forskolin and IBMX (by >80%). OSM and TNF stimulated MMP expression as visualized by zymography, and MMP expression was dose-dependently inhibited by forskolin and IBMX. The highest concentration of IBMX lowered cytokine-induced release of sGAG by 72%. CONCLUSION: Levels of cAMP in chondrocytes play a key role in controlling catabolic activity. Increased cAMP levels in chondrocytes inhibited MMP expression and activity and consequently strongly inhibited cartilage degradation. Specific cAMP modulators in chondrocytes may be potential treatments for cartilage degenerative diseases.     

Factors of Importance to Doppler Indexes of Left Ventricular Filling in 50-Year-Old Hypertensive Persons

Altered left ventricular (LV) diastolic filling has been shown in subjects with hypertension. Age is a major determinant of Doppler indexes of LV diastolic filling; therefore, a group of subjects of uniform age should preferably be chosen, if other determinants of diastolic LV filling are to be studied. A limited body of data is available regarding Doppler indexes of LV filling in hypertensive persons of a similar age. We therefore evaluated 26 hypertensive subjects (13 women and 13 men) 50 years old by Doppler echocardiography. The peak velocity of early diastolic filling (E wave), the peak velocity of atrial filling (A wave), the early-to-atrial peak velocity (E/A) ratio, and the deceleration time of early velocity were measured. The peak E wave velocity was 0.76 ± 0.11 versus 0.62 ± 0.13 m/s (P < 0.005), and the E/A ratio was 1.11 ± 0.24 versus 0.93 ± 0.23 (P < 0.05) in hypertensive women and men, respectively. The peak A wave velocity was increased and the E/A ratio was decreased in both hypertensive women and men compared with healthy 50-year-old subjects. In multivariate analyses, LV diameter, body mass index, and gender correlated with the E/A ratio in hypertensive persons. It is concluded that there is a significant difference in Doppler LV filling indexes between 50-year-old hypertensive women and men. LV diameter, gender, and body mass index are independent determinants of LV diastolic inflow in similarly aged hypertensive persons.     

Division of Labour in Clinical Microbiology

The aim of the study was to describe clinical microbiological practices in a hospital setting. A grounded theory was developed from qualitative data in two steps: initial participant observation to describe the clinical work-flow, and a main case study based on in depth interviews and analyses of work practices using a video-based stimulated recall technique. Six physicians, 2 senior medical laboratory technologists and one head nurse were interviewed in depth based on their organizational positions. Stimulated recall interviews were conducted with 11 nurses, 6 secretaries, 6 medical laboratory technologists, and 3 physicians. An informal clinical microbiological ‘workgroup’ was found to co-operate around two physical objects: the microbiological sample and the laboratory request form. Work organization was divided into planning, based on science and legislations, and performance based on tradition and local supervision. None of the practitioners had a total overview of an analysis cycle, all being occupied with a discrete part of planning, practical work and information management. The conclusion of the study is that fragmentation in the division of labour may be a critical hindrance to development in clinical microbiology. If a common strategy is not shared between specialities and professions, even minor changes in routines by individual practitioners may influence patient outcome.     

Pain drawing evaluation-the problem with the clinically biased surgeon: Intra- and interobserver agreement in 50 cases related to clinical bias

To assess whether the clinical knowledge of the treating surgeon had any effect on the reliability of the pain-drawing evaluation, drawings from 50 low-back pain patients were evaluated by the treating surgeon and by three colleagues who had no clinical knowledge of the patient. The evaluation was repeated after 10 days. The treating surgeons were also blinded to clinical data. The kappa value in the evaluation when the surgeon had clinical knowledge of the patient was lower (0.29 (95% CI 0.13-0.45)) than the kappa value in the evaluations made without clinical knowledge (0.60 (CI 0.45-0.75)). The differences observed in interobserver reliability between open and blind evaluations suggest that clinical knowledge of a patient influences the evaluation of the pain drawings.     

PERIPHERAL NERVE INJURY AS A COMPLICATION OF AXILLARY ARTERIOGRAPHY

Five patients with peripheral nerve injury after axillary arteriography are presented. The clinical and electromyographic pictures of this complication are described. In 4 patients the brachial plexus was damaged due to haematoma or pseudoaneurysm-formation at the site of the arterial puncture. The grave prognosis for this complication is illustrated on the basis of the literature and our cases. Since it is concluded that the prognosis is better if rapid surgical correction of the complication is performed, certain steps to prevent the disabling outcome are proposed.