Koenigbrun7075

The young men also articulated two counter-narratives, in which they deny responsibility for their actions and position themselves as defeated, overpowered, wary, and unheroic. The findings lend support to the idea that there is not only one narrative of young men's suicide, and that competing and contradictory narratives can be found even within a dominant hyper-masculine account of suicidal behavior. Gender-sensitive suicide prevention strategies should not assume that all men share a common understanding of suicide. Suicide can be enacted as both a performance of masculinity and as a resistance to hegemonic gender roles.

Noninsertional Achilles tendinopathy affects both athletes and sedentary individuals, and its incidence is rising. Conservative management is the mainstay of treatment, but a variety of operative techniques have been described to treat recalcitrant cases. We seek to outline the current available evidence for surgical management of noninsertional Achilles tendinopathy.

A systematic review was performed using the MEDLINE and EMBASE databases, and all articles were reviewed by at least 2 authors. Each article was assigned a level of evidence in accordance with the standards of

. The available data were reviewed and a level of evidence was assigned to each intervention of interest, based on the revised classifications of Wright.

A total of 46 articles met inclusion and exclusion criteria. find more There is fair evidence (grade B) in support of open debridement with 1 level II study, 1 level III study, and 8 level IV studies. There is fair evidence (grade B) in support of arthroscopic or minimally invasive surgical techniques. There is poor evidence (grade C) in support of flexor hallucis longus transfer, longitudinal tenotomy, peritenolysis, gastrocnemius recession, and plantaris excision. There is insufficient evidence (grade I) to provide a recommendation about other surgical treatment methods for noninsertional Achilles tendinopathy.



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A total of 46 articles met inclusion and exclusion criteria. There is fair evidence (grade B) in support of open debridement with 1 level II study, 1 level III study, and 8 level IV studies. There is fair evidence (grade B) in support of arthroscopic or minimally invasive surgical techniques. There is poor evidence (grade C) in support of flexor hallucis longus transfer, longitudinal tenotomy, peritenolysis, gastrocnemius recession, and plantaris excision. There is insufficient evidence (grade I) to provide a recommendation about other surgical treatment methods for noninsertional Achilles tendinopathy.Levels of Evidence Level III Systematic review.Streptococcus mutans is considered the primary etiological agent of human dental caries. Glucosyltransferases (Gtfs) from S. mutans play important roles in the formation of biofilm matrix and the development of cariogenic oral biofilm. Therefore, Gtfs are considered an important target to prevent the development of dental caries. However, the role of transcription factors in regulating gtf expression is not yet clear. Here, we identify a MarR (multiple antibiotic resistance regulator) family transcription factor named EpsR (exopolysaccharide synthesis regulator), which negatively regulates gtfB expression and exopolysaccharide (EPS) production in S. mutans. The epsR in-frame deletion strain grew slowly, aggregated more easily in the presence of dextran, and displayed different colony morphology and biofilm structure. Notably, epsR deletion resulted in altered 3-dimensional biofilm architecture, increased water-insoluble EPS production, and upregulated GtfB protein content and activity. In addition, global gene expression profiling revealed differences in the expression levels of 69 genes in which gtfB was markedly upregulated. The conserved DNA motif for EpsR binding was determined by electrophoretic mobility shift assay and DNase I footprinting assays. Moreover, analysis of β-galactosidase activity suggested that EpsR acted as a repressor and inhibited gtfB expression. Taken together, our findings indicate that EpsR is an important transcription factor that regulates gtfB expression and EPS production in S. mutans. These results add new aspects to the complexity of regulating the expression of genes involved in the cariogenicity of S. mutans, which might lead to novel strategies to prevent the formation of cariogenic biofilm that may favor diseases.This article reports the results of a scoping review of research applications of the Family Management Style Framework (FMSF) and the Family Management Measure (FaMM). We identified 32 studies based on the FMSF and 41 studies in which the FaMM was used, 17 of which were based on the FMSF. Both the framework and measure have been used by investigators in multiple countries, with most applications of the FaMM outside the United States. Although the FMSF and FaMM were originally developed for use with families in which there was a child with a chronic physical condition, both have been applied to a broader range of health conditions and to studies focusing on families with an adult member facing a health challenge. Based on our findings, we make recommendations for how researchers can more fully address all aspects of the FMSF.

This meta-analysis aimed to evaluate the effectiveness of low-load Resistance Training (RT) with or without Blood Flow Restriction (BFR) compared with conventional RT on muscle strength in open and closed kinetic chains, muscle volume and pain in individuals with orthopaedic impairments.

Searches were conducted in the PubMed, Web of Science, Scopus and Cochrane databases, including the reference lists of randomised controlled trials (RCT's) up to January 2021.

An independent reviewer extracted study characteristics, orthopaedic indications, exercise data and outcome measures. The primary outcome was muscle strength of the lower limb. Secondary outcomes were muscle volume and pain. Study quality and reporting was assessed using the TESTEX scale.

A total of 10 RCTs with 386 subjects (39.2 ± 17.1 years) were included in the analysis to compare low-load RT with BFR and high or low-load RT without BFR. The meta-analysis showed no significant superior effects of low-load resistance training with BFR regarding leg muscle strength in open and closed kinetic chains, muscle volume or pain compared with high or low-load RT without BFR in subjects with lower limb impairments.

Low-load RT with BFR leads to changes in muscle strength, muscle volume and pain in musculoskeletal rehabilitation that are comparable to conventional RT. This appears to be independent of strength testing in open or closed kinetic chains.

Low-load RT with BFR leads to changes in muscle strength, muscle volume and pain in musculoskeletal rehabilitation that are comparable to conventional RT. This appears to be independent of strength testing in open or closed kinetic chains.The purpose of this study was to examine the amount of attention devoted to data-based decision-making in Curriculum-Based Measurement (CBM) professional development materials. Sixty-nine CBM instructional sources were reviewed, including 45 presentations, 22 manuals, and two books. The content of the presentations and manuals/books was coded into one of four categories (a) general CBM information, (b) conducting CBM, (c) data-based decision-making, and (d) other. Results revealed that only a small proportion of information in the CBM instructional materials was devoted to data-based decision-making (12% for presentations and 14% for manuals/books), and that this proportion was significantly smaller than (a) that devoted to other instructional topics, (b) that expected were information to be equally distributed across major instructional topics, and (c) that recommended by experienced CBM trainers. Results suggest a need for increased attention to data-based decision-making in CBM professional development.

Data on optimal dosing of unfractionated heparin (UFH) in the presence of a direct oral anticoagulant (DOAC) to achieve and maintain an activated clotting time (ACT) of ≥300 seconds during catheter ablation of atrial fibrillation (CA-AF) are limited and prevalence of obesity adds to the unpredictable response to UFH.

One hundred seventeen consecutive patients undergoing CA-AF were prospectively administered weight-adjusted, weight-based UFH using a pre-specified detailed protocol and retrospectively analyzed. Due to lack of distribution of UFH into muscle or adipose tissue and lower degree of vascularity in the latter compartment, each patient's ideal and actual weights were used to determine the adjusted-weight for use in all UFH doses. A UFH bolus of 200 units/kg was administered intravenously followed by an infusion of 35 units/kg/hour. The mean age was 65 years, and 85 patients (72.6%) were male. The average body mass index (BMI) was 30 (range 18-50) kg/m

. After the initial UFH bolus dose, 99 patients (84.6%) achieved ACT ≥300 sec with a mean (± SD) of 380 ± 79 sec. The mean time to reach an ACT ≥300 in all patients was 14.6 ± 12.4 minutes. Among all measured ACT values, 423 (90.8%) were ≥300 seconds. These results were consistent within all BMI categories. There were no intraprocedural thrombotic or hemorrhagic complications. Two patients (1.7%) sustained groin vascular access site hematoma without subsequent intervention and 7 patients (6%) experienced minor oozing post-procedurally.

Our comprehensive weight-adjusted, weight-based UFH protocol, during CA-AF in presence of a DOAC, rapidly achieved and maintained an effective ACT irrespective of BMI.

Our comprehensive weight-adjusted, weight-based UFH protocol, during CA-AF in presence of a DOAC, rapidly achieved and maintained an effective ACT irrespective of BMI.

To examine whether pre-admission community mobility explains the effects of a rehabilitation program on physical performance and activity in older adults recently discharged from hospital.

A secondary analysis of a randomized controlled trial.

Home and community.

Community-dwelling adults aged ⩾60 years recovering from a lower limb or back injury, surgery or other disorder who were randomized to a rehabilitation (

 = 59) or standard care control (

 = 58) group. They were further classified into subgroups that were not planned a priori (1) mild, (2) moderate, or (3) severe pre-admission restrictions in community mobility.

The 6-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counselling, and standard care.

Physical performance was measured with the Short Physical Performance Battery and physical activity with accelerometers and self-reports. Data were analysed by generalized estimating equation models with the interactions of intervention, time, and subgroup.

Rehabilitation improved physical performance more in the intervention (

 = 30) than in the control group (

 = 28) among participants with moderate mobility restriction score of the Short Physical Performance Battery was 4.4 ± 2.3 and 4.2 ± 2.2 at baseline, and 7.3 ± 2.6 and 5.8 ± 2.9 at 6 months in the intervention and control group, respectively (mean difference 1.6 points, 95% Confidence Interval 0.2 to 3.1). Rehabilitation did not increase accelerometer-based physical activity in the aforementioned subgroup and did not benefit those with either mild or severe mobility restrictions.

Pre-admission mobility may determine the response to the largely counselling-based rehabilitation program.

Pre-admission mobility may determine the response to the largely counselling-based rehabilitation program.