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Little is known about physical activity level and knee function including jump capacity and fear of movement/reinjury more than 20 years after injury of the anterior cruciate ligament ( ACL). Seventy persons with unilateral ACL injury participated (23 ± 2 years post-injury): 33 treated with physiotherapy in combination with surgical reconstruction ( ACLR), and 37 treated with physiotherapy alone ( ACLPT). These were compared with 33 age- and gender-matched controls. Assessment included knee-specific and general physical activity level [ Tegner activity scale, International Physical Activity Questionnaire ( IPAQ)], knee function [ Lysholm score, Knee injury and Osteoarthritis Outcome Score ( KOOS)], jump capacity (one-leg hop, vertical jump, side hops), and fear of movement/reinjury [ Tampa Scale for Kinesiophobia ( TSK)]. Outcomes were related to degree of osteoarthritis ( OA). ACL-injured had lower Lysholm, KOOS, and Tegner scores than controls ( P < 0.001), while IPAQ score was similar. ACL-injured demonstrated inferior jump capacity in injured compared with noninjured leg (6-25%, P < 0.001- P = 0.010 in the different jumps), while noninjured leg had equal jump capacity as controls. ACL groups scored 33 ± 7 and 32 ± 7 of 68 on TSK. Lower scores on Lysholm and KOOS symptom were seen for persons with moderate-to-high OA than for no-or-low OA, while there were no differences for physical activity and jump capacity. Regardless of treatment, there are still negative knee-related effects of ACL injury more than 20 years later. [ABSTRACT FROM AUTHOR]

The xylem surface of seedlings, stem material and roots of Norway spruce ( Picea abies) and Scots pine ( Pinus sylvestris) were inoculated with strains of Heterobasidion annosum s. str. and H. parviporum s. str. The depth of necrosis in wounded spruce increased at a linear rate for at least seven weeks of incubation, but the rate of necrotic spread was significantly faster in infected wounds. In wounded pine the necrosis was maintained at a more superficial level for several weeks. Both spruce and pine sapwood were initially infected by hyphae of both species. In spruce, the hyphae advanced at a constant rate behind the necrotic front. On the contrary, after 1–2 weeks living H. parviporum hyphae were rare in pine rays. Heterobasidion annosum hyphae survived in pine rays, phloem and tracheids, despite a heavy accumulation of phenolics and resins and were able to penetrate into the sapwood at a linear rate although slower than infections in spruce. Histochemistry and quantitative estimates demonstrated that peroxidase activity was initially higher in spruce sapwood than in pine. Within three days of incubation, the activity in spruce sapwood disappeared concurrently with deepening necrosis. However, in pine, in both control and infected samples, there was a significant increase in peroxidase activity in the area surrounding the superficial necrosis, up to the wound surface and in the cambium and phloem around the wound. After wounding and infection, the content of soluble protein increased significantly in wood of older trees but not in seedlings. Infection resulted in an increased formation of lipophilic extractives in both spruce and pine but to a significantly greater degree in the latter, whereas the amount of hydrophilic compounds decreased in both. High-performance liquid chromatography (HPLC) analyses of lipophilic extracts showed that inoculation of pine with the two species of Heterobasidion increased the amounts of pinosylvin, its monomethylether and several other phenolics as also resinous compounds. The results obtained may be relevant in explaining the known higher resistance of Scots pine to H. parviporum. [ABSTRACT FROM AUTHOR]

In response to infection by Heterobasidion annosum in Norway spruce bark, concentrations of the stilbene glucosides isorhapontin and astringin decreased, and small amounts of the highly toxic aglucone isorhapontigenin appeared. Concentrations of a third stilbene glucoside, piceid did not change following infection. The initial concentration of astringin was inversely correlated with the infection depth after 7 days, suggesting that the compound contributes to the resistance of the host. Concentrations of all three stilbene glucosides varied considerably between trees and between seasons, i. e. they increased during autumn and decreased during spring. The astringin content was higher in stems than in roots and increased towards the outer part of the inner bark. The content of resin acids increased in response to infection, but their concentrations were not correlated with the depth of fungal colonisation. [ABSTRACT FROM AUTHOR]

An applicator for intracavitary hyperthermia treatment of cancer has been designed and tested. The applicator is a section of a dielectric-loaded circular ridge waveguide closed at both ends to form a transmission cavity. An aperture in the cavity wall can produce a directed heating of a tumor growing in the wall of a body cavity such as the vagina. [ABSTRACT FROM AUTHOR]

Background and Objectives: Initiation and engagement, performance measures that focus on the frequency and timely receipt of services in the early stages of substance use disorders (SUD) treatment, are useful tools for assessing treatment quality differences across racial/ethnic groups. The purpose of this study was to examine whether there are racial/ethnic disparities in these quality indicators and to explore whether predictors of treatment initiation and engagement differ by clients' race/ethnicity., Methods: This study used administrative data from outpatient treatment facilities licensed by the state of Massachusetts that receive public funding. The sample consisted of 10,666 adult clients (76% White, 13% Latino, 11% Black) who began an outpatient treatment episode in 2006. Client data were linked with facility data from the National Survey on Substance Abuse Treatment Services. Multilevel regressions were used to examine racial/ethnic disparities and to explore whether predictors for initiation and engagement differed by client's race/ethnicity., Results: We did not find evidence of racial/ethnic disparities in treatment initiation or engagement. However, we found that predictors of initiation and engagement differed by client's race/ethnicity., Conclusions and Scientific Significance: Disparities may be context specific, and thus it is important that they be examined at state or local levels. Our results point to the importance of examining predictors of quality indicators separately by group to better understand and address the needs of diverse client populations., (© American Academy of Addiction Psychiatry.)

This national study of addiction-treatment organizations' implementation of evidence-based practices examines: (1) organizational/leadership factors associated with director (n = 212) attitudes regarding staff resistance to organizational change, and (2) organizational/staff factors associated with staff (n = 312) attitudes regarding evidence-based clinical training. Linear regression analyses, controlling for type of treatment unit, leadership/staff characteristics and organizational readiness to change, identified that directors who perceived their organization needed more guidance and had less staff cohesion and autonomy rated staff resistance to organizational change significantly higher. Staff with higher levels of education and greater agreement that their organization supported change had greater preference for evidence-based trainings. Federal addiction treatment policy should both promote education and training of treatment staff and organizational development of treatment CBOs. , (© American Academy of Addiction Psychiatry.)

This study explored the frequency of drug treatment utilization by 36,081 injection drug users (IDUs) in Massachusetts, 1996-2002. A number of multiple and logistic regression analyses examined the relationship between demographic characteristics, parental status, level of and type of drug use, history of mental health treatment use, types of drug treatment entered, and the number of times an IDU had entered drug treatment for the seven-year time period. Homelessness, using heroin as the primary drug of choice, and health insurance status were all associated with number of treatments entered. Logistic regression analysis identified that health insurance was a key factor associated with more frequent treatment: those with private health insurance were ten times more likely to be in the 90th percentile (12-107 entries) with respect to number of treatment entries.

This study examined the relationship between substance abuse treatment use, health services use, HIV status, and emergency room/hospital use for 507 injection drug users (IDUs). Logistic regression models showed that mental health status, severity of drug use and private health insurance were significantly associated with having used emergency room/hospital services in the past six months. History of substance abuse treatment use, positive HIV/AIDS diagnosis, mental health service use, ethnic/racial background, gender, age, education and homelessness were not significant at either the bivariate or the multivariate level. These results point to the need to improve mental health screening and referrals through emergency room medical systems.

Background: Flour dust in bakeries is known to cause allergic as well as nonallergic respiratory symptoms. Fungal alpha-amylase is a commonly used baking additive that has been shown to have allergenic properties. The aim of this study was to investigate any effects on bronchoalveolar lavage (BAL) cells and peripheral blood lymphocytes (PBL) of healthy individuals exposed to airborne wheat flour dust with or without fungal alpha-amylase added., Methods: Fifteen subjects were exposed during 1 hr in an exposure chamber, ten individuals to wheat flour alone and five with alpha-amylase added. BAL was performed 2-6 weeks before and 1 day after the exposure. BAL cells were differentially counted and flowcytometric analysis of the expression of activation, adhesion, and subset markers on alveolar macrophages (AM) and T cells in BAL fluid and peripheral blood were carried out., Results: Exposure to wheat flour dust increased the total number of cells in BAL fluid from 75.4 (i.q. range 70.4-104.1) to 127.4 (92.1-187.4) cells x 10(6)/L, P < 0.01. There was a significant difference in the change of total BAL cell concentration between the study group exposed to wheat flour only (n = 10; increase with 91.9 x 10(6)/L) and the group exposed to wheat flour with the baking additive fungal alpha-amylase (n = 5; decrease with 5.4 x 10(6)/L). The exposure level of respirable dust was lower in the group that received alpha-amylase and the increase in BAL cell concentration showed a positive correlation with the concentration of respirable dust in the exposure chamber (r = 0.80, P < 0.001). The phenotypic analysis of AM indicated an influx of monocytic cells., Conclusions: The results indicate that the concentration of respirable dust, but not alpha-amylase, is of importance for the recruitment of inflammatory cells to the peripheral airways in healthy individuals exposed to wheat flour dust., (Copyright 2003 Wiley-Liss, Inc.)