The relationship between academic success and sleep, stress and quality of life during the first year of physical therapy school.

Objective: The purpose of this study was to investigate the association between academic success and changes in predictor variables of aerobic fitness, sleep, stress and quality of life (QOL) in students enrolled in the first year of a physical therapist education program. Participants: This prospective longitudinal cohort study utilized 37 first-year Doctor of Physical Therapy students. Methods: We investigated the association between grade point average (GPA) and the various predictor variables. A multiple logistic regression model with backward selection was used to predict GPA. GPA greater than or equal to 3.5 or below 3.5 out of a 4.0 scale were used as the dichotomous events. Results: The regression model with the selected-out predictors was a good fit (p = 0.011). About 60% of the variation in the outcome GPA binary can be explained by the selected predictors that were the changes in sleep and QOL. Conclusions: Achieving academic success can be affected by changes in sleep and QOL.

Health-Related Quality of Life in Children With Chronic Illness Compared to Parents: A Systematic Review.

PURPOSE: The purpose of this systematic review is to identify quality-of-life issues that affect participation in age-appropriate activities in chronically ill children, as reported by the children and their families. SUMMARY OF KEY POINTS: Social and emotional functioning scores on the Pediatric Quality of Life Inventory (PedsQL) 4.0 were found to have the greatest frequency of poor agreement between parents and children in 4 of the 6 studies included in this review, suggesting parents and children have wide variation in their assessment in these areas of psychosocial function. CONCLUSIONS: Cumulative evidence appears to indicate that parents of children with chronic illness perceive their children as having a poorer quality of life than the children report for themselves. RECOMMENDATIONS FOR CLINICAL PRACTICE: Identifying differences and commonalities between these reports can guide health care practitioners to specific activities that should be the focus of caring for children; specifically, functional goal development can become more personalized and appropriate.

Treatment of Pediatric Overweight and Obesity: Assessing the Options.

BACKGROUND: Obesity in the United States has been identified as one of the most prevalent health epidemics affecting both adults and children, and it has become the focus of a variety of primary, secondary, and tertiary healthcare interventions. OBJECTIVES: To summarize and assess the efficacy of current practices in the management and treatment of pediatric overweight and obesity. METHODS: An extensive review of the literature was performed. This review examined five areas of intervention most commonly used to manage and treat pediatric overweight and obesity: physical activity, nutritional and behavioral interventions, pharmaceutical management, and surgical procedures. RESULTS: Of 82 sources, 43 studies met our inclusion and exclusion criteria. However, after evaluating study strength using the PEDro, 24 were included in this systematic review. The studies, which included RCTs and cohort studies of levels I and II evidence, respectively, were evaluated for methodological quality using the PEDro scale. Programs that combined decreased sedentary behaviors and nutritional modifications had the most significant results in changes in body mass index (BMI) and weight gain or weight loss. CONCLUSION: To ensure successful management and treatment of pediatric obesity, the most successful paradigm of intervention is through a multidisciplinary approach: physical activity, nutrition, and behavioral strategies. Behavioral interventions should support and reinforce physical activity and nutritional modifications. Because of the potential health risks involved to the child, pharmaceutical and surgical approaches are considered only when all other interventions have failed.

Epidemiology of injuries in the elite level female high school lacrosse player.

Female lacrosse has grown 219% in the last decade. This descriptive study explored the epidemiology of elite female high school lacrosse injuries and compared them with those in the collegiate player. Five hundred surveys were completed at tournaments in the northeast United States. Over 60% played other sports; 50% experienced a new injury while playing lacrosse, and 16% had a recurrent injury from another sport. The ankle, knee, and head were most commonly injured. Eleven percent of respondents sustained a concussion; 35% of these experienced some loss of consciousness. Eighty-four percent of injuries occurred via contact. Forty-two percent (42%) of athletes lost 10 or more days of playing time. Frequency data showed that reported injuries are high for elite lacrosse, which is classified as a noncontact sport, and are comparable with those seen in the collegiate player.

Inhaled NO accelerates restoration of liver function in adults following orthotopic liver transplantation.

Ischemia/reperfusion (IR) injury in transplanted livers contributes to organ dysfunction and failure and is characterized in part by loss of NO bioavailability. Inhalation of NO is nontoxic and at high concentrations (80 ppm) inhibits IR injury in extrapulmonary tissues. In this prospective, blinded, placebo-controlled study, we evaluated the hypothesis that administration of inhaled NO (iNO; 80 ppm) to patients undergoing orthotopic liver transplantation inhibits hepatic IR injury, resulting in improved liver function. Patients were randomized to receive either placebo or iNO (n = 10 per group) during the operative period only. When results were adjusted for cold ischemia time and sex, iNO significantly decreased hospital length of stay, and evaluation of serum transaminases (alanine transaminase, aspartate aminotransferase) and coagulation times (prothrombin time, partial thromboplastin time) indicated that iNO improved the rate at which liver function was restored after transplantation. iNO did not significantly affect changes in inflammatory markers in liver tissue 1 hour after reperfusion but significantly lowered hepatocyte apoptosis. Evaluation of circulating NO metabolites indicated that the most likely candidate transducer of extrapulmonary effects of iNO was nitrite. In summary, this study supports the clinical use of iNO as an extrapulmonary therapeutic to improve organ function following transplantation.

Weighing in on the issues of type 2 diabetes in children: a review.

PURPOSE: The purpose of this review is to present the clinical issues, including risk, etiology, screening and identification, complications, management, and prevention of type 2 diabetes mellitus (T2DM) in children and to discuss the role of the pediatric physical therapist in effectively managing children with T2DM. SUMMARY OF KEY POINTS: In studies done worldwide, T2DM is being diagnosed in children at rates much greater than that of type 1 diabetes. Sedentary lifestyle and the high prevalence of obesity are the primary problems, setting the stage for a lifetime of health complications for many of today's youth. RECOMMENDATIONS: Health care providers must understand this disease to ensure proper management. A multidisciplinary approach is advocated for those children who are at risk for and diagnosed with T2DM to help prevent the disabling and often incapacitating complications associated with T2DM.

Surveillance for avian influenza in the United States.

In the United States, some 1.7 million agar gel immuno diffusion (AGID) tests for avian influenza (AI) are conducted yearly by various poultry groups, governmental sectors, and private industry. In addition to the AGID test, additional testing includes virus isolations, enzyme-linked immunosorbent assays, real-time reverse transcriptase polymerase chain reactions, and hemagglutination inhibition (HI) tests. HI and neuraminidase inhibition tests are conducted on positive AGID samples to determine the subtype. Directigen, a type of antigen capture test, is used in the field in some cases. If monitoring and surveillance activities give rise to a suspicious test result, the accredited veterinarian and official State laboratory are required to report these to the governmental authorities. A thorough investigation in collaboration with the National Veterinary Services Laboratories (a World Organization for Animal Health--AI reference laboratory), State and Federal veterinarians, and others is conducted. Testing conducted as part of the National Poultry Improvement Plan (NPIP) effectively monitors the status of breeder and multiplier flocks. A new commercial poultry program is being added and will expand NPIP AI testing to all commercial flocks. Private poultry companies conduct additional tests; and in the poultry-producing States, there are active state-wide programs to monitor poultry health. All components of the live-bird market system (source flocks, haulers, dealers, and markets) are tested under the Low Pathogenicity AI Live-Bird Market Program.

Impact of avian influenza on U.S. poultry trade relations-2002: H5 or H7 low pathogenic avian influenza.

Avian influenza (AI) viruses are Type A influenza viruses of the Orthomyxoviridae family. There are 15 subtypes of the virus widespread in migratory waterfowl throughout the world. It has become increasingly evident that some low pathogenic avian influenza (LPAI) H5 or H7 viruses have the capacity to mutate into the more virulent strains that cause extensive economic losses and high mortality. Recent AI disease outbreaks in several countries have increased attention and concern over low pathogenic H5 and H7 AI viruses. This heightened international concern increases the risk of unnecessary trade bans. For the US poultry industry, avian influenza continues to be a challenge to the flow of trade. On one hand, there is the increased focus of world attention on the H5 and H7 low pathogenic AI virus and the possibility of mutation. On the other hand, there are the factors contributing to our finding of infected flocks. Among these, perhaps the most important is the ever-present reservoir of virus in the migratory waterfowl population. With the discovery of exposed flocks comes the threat of trade bans.

Characterization of T-cell lymphomas associated with an outbreak of reticuloendotheliosis in turkeys.

Increased mortality and decreased egg production associated with disseminated lymphoma were observed in a turkey breeding flock for more than 20 weeks. A few unrelated meat turkey flocks, from the same integrator, experienced increased condemnation due to neoplasia in a few organs. Lymphoma was characterized by a uniform population of large lymphocytes with large vesicular nuclei containing one or two nucleoli and with little, faintly staining, basophilic cytoplasm. Neoplastic cells replaced normal tissue and were consistent with lesions seen with reticuloendotheliosis virus (REV) infection. Immunoperoxidase and fluorescent antibody staining characterized the neoplastic cells as CD3+, CD4+ and CD8- lymphocytes. Infection with REV was confirmed by virus isolation, polymerase chain reaction, serology and indirect fluorescent antibody. Poults hatched from these breeders tested positive for REV antibodies at hatch, but the performance of these flocks was normal and lymphoma was not observed. The origin of REV infection in this outbreak could not be determined. This is the first documented report of T-cell lymphomas associated with REV in commercial flocks. Furthermore, this is the first time that lymphomas have been characterized as T helper cells (CD3+ CD4+ and CD8-) in an outbreak of REV in turkeys.

Avulsion of the common retinaculum in meat turkeys.

An increase in leg condemnations was experienced in several commercial meat flocks of male and female turkeys. Affected legs had hematomas around and above the tibiotarsus-tarsometatarsus (hock) joint. Avulsion of the common retinaculum from the external condyle was observed when the skin and muscular fascia were removed. A farm investigation was performed and similar changes were observed in turkeys between 10 and 19 wk of age. Interestingly, birds with avulsion of this fibrinous bridge were not lame. Body weights were normal, no infectious agent was detected, and mineral contents of bones and tendons were within normal limits. Avulsion of the retinaculum might not have been diagnosed in the past because the birds are not lame and the lesion is tightly covered by the skin and muscular fascia.