视觉预期和注意指向对姿势和动作肌肉预期和补偿姿势调节的影响

采用经典落球试验研究范式,同步观察视觉预期和注意指向对腰部姿势肌肉和上肢运动肌肉预期和补偿姿势调节的影响,探索视觉预期和注意指向影响姿势控制的早期心理生理机制。24名青年志愿者(10名男性,14名女性)参与完成本实验,分别在有、无视觉预期以及注意指向"托盘稳定"或者"重心稳定"的实验条件下观察外部姿势干扰对腰部姿势肌肉(L5~S1腰部多裂肌)和上肢动作肌肉(肱二头肌)预期姿势调节(anticipatory postural adjustments,APAs)和补偿姿势调节(compensatory postural adjustments,CPAs)相关时间和强度参数的影响。APAs和CPAs的时间和强度参数通过获取被检肌肉s EMG信号并参照相关检测规范进行。结果显示:(1)视觉预期对多裂肌的APAs启动时间,对肱二头肌的APAs启动时间、APAs强度和CPAs强度有显著影响;(2)注意指向对多裂肌的CPAs启动时间和肱二头肌APAs启动时间有显著影响;(3)视觉预期和注意指向对肱二头肌的APAs启动时间和APAs强度有交互作用。研究认为,突发外部姿势干扰条件下姿势肌肉和动作肌肉的姿势调节策略具有一定的差异,视觉预期和注意指向仅对姿势肌肉的时间参数有影响,对动作肌肉APAs和CPAs时间和强度参数都产生调节作用,表明在中枢神经系统的姿势控制中,人体姿势策略的调节是通过对姿势肌肉和动作肌肉的双重控制来完成的,视觉预期效应和心理指向效应反映在对不同功能肌肉前馈控制和反馈控制相应参数的调节。     

Body mass index,inflammatory biomarkers and neurocognitive impairment in HIV-infected persons

To determine the relationships among body mass index (BMI), and HIV-associated neurocognitive impairment and the potential mediating effects of inflammatory cytokines. Among the HIV-infected individuals (N = 90) included in this study, obesity was associated with slower processing speed (β = ?.229, standard error (SE) = 2.15, p = .033), compared to participants with a normal BMI, after controlling for psychosocial and HIV clinical factors. Serum concentrations of the interleukin-16 (IL-16) cytokine were significantly associated with slowed processing speed (β = ?.235, SE = 1.62, p = .033) but did not mediate the relationship between obesity and processing speed These findings suggest that obesity may contribute to cognitive processing speed deficits in HIV-infected adults. Elevated concentrations of IL-16 are also associated with slowing, though the results suggest that obesity and IL-16 may exert independent effects.     

论"以人为本"的新大众保健观--提高全民健康素质的重要话题

21世纪的新大众保健观,应及时反映科学发展的新成就,以更好地服务于大众不断提高健康需求.为此,高度重视重构和宣传"以人为本"的新大众保健观,理应成为全面小康社会公共卫生建设的一个重要话题.     

Weighted vest effects on impact forces and joint work during vertical jump landings in men and women

Weighted vest (WV) use during vertical jump landings (VJL) does not appear to alter peak vertical ground reaction forces (GRF) or peak joint torques. However, WV effects on joint work and sex differences during VJL are not well understood. This study assessed WV effects on vertical GRF and sagittal joint work during VJL in men and women. Twelve men and 12 women performed VJL wearing a WV with zero added mass (unloaded) and with 10% body mass (loaded) while GRF and kinematic data were obtained. Mixed-model analyses of variance (α = 0.05) and effect sizes (ES) were used to assess differences between sexes and/or load conditions. Regardless of sex, greater landing height (p < 0.001; ES = 0.37) and peak vertical GRF (p = 0.001; ES 0.51) occurred when unloaded, while greater landing time (p = 0.001; ES = 0.46) and negative lower extremity work (p < 0.001; ES = 0.41) occurred when loaded through greater negative work about the hip (p = 0.001; ES = 0.27) and ankle (p = 0.020; ES = 0.27). No differences in hip (p = 0.753; ES = 0.03), knee (p = 0.588; ES = 0.07), or ankle (p = 0.580; ES = 0.09) joint displacement were detected between loaded and unloaded conditions. Men exhibited greater landing heights (p < 0.001; ES = 2.49) and greater peak vertical GRF than women (p = 0.007; ES = 1.18), though women exhibited greater negative lower extremity work (p < 0.001; ES = 1.98) than men through greater negative knee (p < 0.001; ES = 1.98) and ankle (p = 0.032; ES = 0.94) work. No sex differences were detected for joint angular displacement about the hip (p = 0.475; ES = 0.30), knee (p = 0.666; ES = 0.18), or ankle (p = 0.084; ES = 0.71). These data revealed a unique load accommodation strategy during VJL with a WV characterized by greater lower extremity joint work performed via increased joint torque despite lesser landing height and peak vertical GRF. Women appear to perform greater lower extremity joint work than men during VJL despite lesser landing height and peak vertical GRF. Current and prospective WV users should be aware of their load accommodation strategy during VJL with an external load. Women may consider developing more refined load accommodation strategies for VJL regardless of whether external loading is applied to avoid performing excessive amounts of lower extremity work.     

Effects of vision and cognitive load on anticipatory and compensatory postural control

This study assessed the effects of vision and cognitive load on anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) in response to an externally triggered postural perturbation. A ball-hitting test was repeated under different visual conditions (eyes open, EO; eyes closed, EC) and cognitive loads (no load, 3-subtraction task, time-limited 3-subtraction task). Data were collected separately for I) surface electromyography from the right side of the biceps brachii (BIC) and erector spinae (ES) to detect the latency and response intensity (RI); and II) displacement of the centre of pressure (ΔCOP) to detect the standard deviation (ΔCOP_SD) and maximum value (ΔCOP_max) in the anterior-posterior direction. Compared with the results under the EC condition, the ES latency was shorter and the RI of the BIC was lower under the EO condition. Accordingly, the ΔCOP_SD and ΔCOP_max were increased in the APAs phase and decreased in the CPAs phase. Cognitive load had no effect on APAs and CPAs or on ΔCOP in the APAs phase. However, ΔCOP_max was decreased in the CPAs phase during the EC condition. In conclusion, vision played an important role in APAs and CPAs for muscle activation and ΔCOP. Cognitive load had no effect on neuromuscular APAs or CPAs except when the postural perturbation occurred when visually unexpected.     

Effect of body configuration at step contact on balance recovery from sideways perturbations

Compensatory stepping is an important protective mechanism to prevent falling. To recover from sideways perturbations side steps are generally more advantageous than cross-over steps. However, there is lack of understanding of the characteristics of compensatory side steps following sideways perturbations that separate successful recoveries (i.e., no falls) from falls, the most clinically relevant outcome following a balance perturbation. We aimed to identify the critical determinants for successful side stepping after large sideways balance perturbations. Twelve healthy young adults were subjected to large leftward perturbations at varying intensities on a translating sheet. For recovery attempts started with a side step, we determined body configuration variables (frontal-plane leg and trunk angle) at first step contact, as well as spatiotemporal step variables (onset, length, duration, velocity). A logistic regression analysis was conducted to determine the predictive ability of body configuration and spatiotemporal variables on the probability of success (no fall vs. fall); perturbation intensity (peak jerk of translating sheet) and a random effect for individual were also included in the model. In the final model, leg angle and peak jerk were retained as predictors of successful balance recovery and these variables correctly classified the recovery outcome in 86% of the trials. This final ‘body configuration’ model yielded a −2 log likelihood of −36.3, whereas the best fitting model with only spatiotemporal variables yielded a −2 log likelihood of −45.8 (indicating a poorer fit). The leg angle at a given perturbation intensity appears to be a valid measure of reactive side step quality. The relative ease of measuring this leg angle at step contact makes it a candidate outcome for reactive stepping assessments in clinical practice.     

Locomotor pattern and mechanical exchanges during collective load transport

While the locomotor behavior of humans walking alone, loaded or unloaded, has been extensively studied, the locomotor behavior of humans transporting a load collectively is very poorly documented in the biomechanics literature. Yet, collective carriage is a task commonly performed in sport (CrossFit), military and health care (carriage of an injured person) activities and is a task that raises growing interest in robotics (Cobots). The primary aim of our research was to test the hypothesis that the mechanical cost of locomotion is comparable when two individuals are transporting an object collectively and when they are walking alone. To test this, the movements of ten pairs of individuals walking side by side, separately or while transporting collectively an object, were recorded with a three-dimensional motion analysis system (Vicon©). Our results show a similar pattern in the periodic displacement of the center of mass and in mechanical costs, between individuals walking alone and individuals carrying a load collectively. Moreover, a better pendulum-like behavior was found in the sagittal plane and in 3D for the pairs of individuals carrying an object, which suggests that the saving in mechanical exchanges is higher when two individuals are carrying an object collectively than when they are walking alone. The values of the parameters measured in our experiment could be used as a benchmark for the implementation of collective carriage tasks in robotics.     

Genetic Counseling and Screening of Consanguineous Couples and Their Offspring: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic counseling and screening for consanguineous couples (related as second cousins or closer) and their offspring with the goals of1. providing preconception reproductive options2. improving pregnancy outcome and identifying reproductive choices3. reducing morbidity and mortality in the 1st years of life, and4. respecting psychosocial and multicultural issues.The recommendations are the opinions of a multicenter working group (the Consanguinity Working Group (CWG)) with expertise in genetic counseling, medical genetics, biochemical genetics, genetic epidemiology, pediatrics, perinatology, and public health genetics, which was convened by the National Society of Genetic Counselors (NSGC). The consensus of the CWG and NSGC reviewers is that beyond a thorough medical family history with follow-up of significant findings, no additional preconception screening is recommended for consanguineous couples. Consanguineous couples should be offered similar genetic screening as suggested for any couple of their ethnic group. During pregnancy, consanguineous couples should be offered maternal–fetal serum marker screening and high-resolution fetal ultrasonography. Newborns should be screened for impaired hearing and detection of treatable inborn errors of metabolism. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

Difficult Patients in Group Analysis: The Personification of (ba) I:A/M

Following a discussion of the treatment of difficult patients in group analysis, two theories are proposed concerning a fourth basic assumption in the unconscious life of groups, called Incohesion: Aggregation/Massification or (ba) I:A/M and the personification of basic assumption processes, in particular that of (ba) I:A/M by difficult patients. These theories are illustrated with clinical data. Special attention is given to crustacean and amoeboid forms of encapsulation as a defence against the fear of annihilation within the context of the traumatogenic process. It is suggested that for difficult patients the treatment of choice is dyadic psychotherapy/psychoanalysis followed by group analysis.     

Mirror,mirror - Does the fitness club industry have a body image problem?

The primary aim of the present study was to report longitudinal data on body image across the first year of gym engagement. Second, we aimed to compare body image among those who reported regular use of the fitness club (≥2 sessions/week) with those who did not (≤1exercise session/week or no exercise/dropout), as well as between genders and Body Mass Index groups (BMI<25 and BMI≥25) at membership start-up. Novice exercisers (n = 250) from 25 fitness clubs in Oslo (Norway) responded to an online questionnaire at start-up, three, six and 12-months follow-up, with a high response rate (100%, 89.6%, 85.2% and 74.8%). The questionnaire covered background/health information and exercise involvement. A modified Multidimensional Body Self Relations Questionnaire Appearance Scales (MBSRQ-AS), comprising five subscales (appearance satisfaction, appearance investment, weight-related attitude, self-classified weight and Body Areas Satisfaction Scale (BASS), was used to gather repeated measures of body image. Data were analysed separately for each subscale and as a body image total score, using a linear mixed model adjusted for baseline, gender and BMI. We found differences in body image total score reported at six months when compared with onset (0.04, 95% CI 0.005–0.078, p = 0.024), whereas the subscale appearance satisfaction was different at three (0.08, 95% CI 0.015–0.164, p = 0.018), six (0.11, 95% CI 0.039–0.197, p = 0.003) and twelve (0.10, 95% CI 0.021–0.179, p = 0.013) months when compared with onset. Also the subscale BASS was different at three (0.17, 95% CI 0.009–0.255, p < 0.001), six (0.21, 95% CI 0.127–0.301, p < 0.001) and twelve (0.26, 95% CI 0.143–0.388, p < 0.001). Participants adhering to regular exercise (≥2 times weekly) had better outcomes on total body image than those who exercised less frequently or irregularly (three: 2.94 vs. 2.83, p = 0.027 and 12-months: 2.97 vs. 2.85, p = 0.028).At membership start-up, being male (p < 0.001) and having a BMI<25 (p = 0.003), were the strongest factors associated with reporting a higher score on total body image. In conclusion, we found improved body area and appearance satisfaction in novice exercisers across the first year of fitness club membership.