Blackberry (United States)

Two types of midsole technology have recently become widely available in the running shoe market: conventional running shoes (CRS) and technologically advanced running shoes (TARS).CRS are neutral, cushioning running shoes (N-running shoes) and medially supporting or motion-controlling shoes (C-running shoes).The evolution of CRS can be traced back to 1980, with the primary objective of safeguarding runners from physical harm.The advent of technologically advanced running shoes (TARS) in the post-2015 era signaled a paradigm shift in the realm of footwear technology, with a focus on enhancing both comfort and performance.These devices have been referred to as "Super-shoes".Subsequently, in 2019, a novel technical solution was introduced within the TRAS category, with the primary objective of mitigating the risk of running-related injuries (RRIs) by decreasing tissue loading and enhancing running comfort.The impact of running shoes with a U-shaped midsole construction (U-TECH TM ) and highly cushioned, responsive foam on the biomechanics of the lower extremities is significant.The footwear, which has been meticulously engineered to align with the biomechanics of running, is designated as U-running shoes.Recent biomechanical studies demonstrate that the midsole construction and material of the four running shoe categories (N, C, S, and U) systematically modulate joint moments at the foot, ankle, and knee joints, as well as the mechanical loading of the lower extremity's biological structures during running.A six-month randomized controlled interventional trial surveyed 414 recreational runners who used one of the four dedicated running shoe categories (N, C, S, or U) for more than 80% of their runs.A total of 98 runners were randomly provided with U-running shoes; 204 runners used self-selected N-shoes; 56 runners ran in C-shoes; and 56 runners practiced in S-shoes.We prospectively followed 414 participants for 25 weeks regarding RRI and running behavior.All information about sports practices and injuries was documented in an online diary and checked for consistency and completeness.RRI was defined as any pain sustained during or because of running that impeded normal running activity for at least one day.Binary logistic regressions were used to identify RRI risk factors.In this randomized controlled interventional trial, the objective was to determine whether recreational runners who utilize technologically advanced running shoes (TARS) exhibit a reduced risk of sustaining running-related injuries.The results of the study demonstrate a robust relationship between running-related injuries and footwear categories, particularly knee, Achilles tendon, and foot/ankle injuries.The logistic regression model with the N (neutral) footwear category as reference revealed increased ODD ratios of RRIs for the S-and C-running shoes (S: OR=1.325; 95% CI 0.700 to 2.508, C: OR=1.378; 95% CI 0.737 to 2.577) and significantly decreased ODDs for the U-footwear technology (U: OR=0.392; 95% CI 0.225 to 0.683).Neutral (N) and motion control (C) running shoes showed no significant difference in the development of running-related injuries to the knee, the Achilles and foot/ankle.However, S-and U-running shoes increased and decreased this risk, respectively, especially for knee pain, Achilles tendon issues, and foot/ankle injuries.In this six-month prospective study, the development of running-related injuries was found to be only marginally influenced by additional risk factors, including age, gender, BMI, running distance, and practicing frequency.In summary, the latest advancements in running shoe midsole technologies offer a nuanced and empirically substantiated account of the underlying mechanisms that link overuse injuries to the biological structures of the lower extremities with running-related injuries.

Chronic pain is an ever-increasing global challenge, and few strategies have been shown to significantly alter this trajectory, and a pure pharmaceutical approach, especially opioids, is not the answer. To truly impact a person with chronic pain’s life, current best-evidence supports changing their cognitions (how they think about their pain), moving more, and calming the peripheral and central nervous system, including non-pharmacological strategies. All healthcare providers, however, must use a unified strategy regardless of their professional designation, skillset, and clinical setting. One variable that spans all patient interactions is communication. All healthcare providers talk to patients, be it during informal, casual conversation or during specific medical education tied to diagnosis, prognosis, treatment, reassurance, and more. Current evidence supports teaching patients more about their pain experience, called pain neuroscience education (PNE), which has significant clinical benefits. Any provider may offer PNE, from physicians, pharmacists, therapists, psychologists, nurses, etc. Pain neuroscience education is shown to positively influence self-reported pain, disability, fear-avoidance, pain catastrophizing, movement, and healthcare utilization in patients with chronic pain. This commentary aims to introduce all healthcare providers to PNE, and how, along with non-pharmacological treatments (PNE+) have the ability to positively impact people’s lives living with chronic pain.

Background: An extreme fear of needles results in patients avoiding procedures that involve needle exposure, potentially compromising their health outcomes. Virtual reality is a simulated three-dimensional environment created using an audio-visual headset that may reduce patients’ level of anxiety during needle exposure. Aims: The primary aim of the study is to determine the feasibility of using virtual reality to manage anxiety and reduce fear during intravenous cannulation. The safety and experiences of patients and health care professionals using virtual reality will be explored. Methods: This feasibility study will use mixed methods. Participants will undergo needle exposure with standard care and the virtual reality intervention. Quantitative data of physiological vital signs and qualitative data, gathered using semi-structured interviews, will be used to describe participants’ physiological and anxiety responses. Both patient and clinician experiences of, barriers to and enablers of the virtual reality intervention will be explored. Discussion: Distraction therapy using a virtual reality simulated environment has the potential to reduce negative patient reactions associated with needle phobia. If virtual reality is found to be a feasible distraction therapy for adult patients with needle fear, then larger trials can be undertaken to determine the effectiveness of the intervention as part of usual practice.

ObjectivesResearch suggests that attendance by physical therapists at continuing education (CE) targeting the management of low back pain (LBP) and neck pain does not result in positive impacts on clinical outcomes. The aim of this study was to determine if therapists attending a self-paced 3-hour online Pain Neuroscience Education (PNE) program was associated with any observed changes to patient outcomes and also clinical practice.MethodsParticipants were 25 different physical therapists who treated 3,705 patients with low back pain (LBP) or neck pain before and after they had completed an online PNE CE course. Change in outcomes measures of pain and disability at discharge were compared for the patients treated before and after the therapist training. Clinical practice patterns of the therapists, including total treatment visits, duration of care, total units billed, average units billed per visit, percentage of ‘active’ billing units and percentage of ‘active and manual’ billing units, were also compared for the patient care episodes before and after the therapist training.ResultsThere was no significant difference for change in pain scores at discharge for patients treated after therapist CE training compared to those treated before regardless of the condition (LBP or neck pain). However, patients with LBP who were treated after therapist CE training did report greater improvement in their disability scores. Also after CE training, for each episode of care, therapists tended to use less total visits, billed fewer units per visit, and billed a greater percentage of more ‘active’ and ‘active and manual’ billing units.DiscussionAttending an online 3-hour CE course on PNE resulted in improved disability scores for patients with LBP, but not for those with neck pain. Changes in clinical behavior by the therapists included using less visits, billing fewer total units, and shifting to more active and manual therapy interventions. Further prospective studies with control groups should investigate the effect of therapist CE on patient outcomes and clinical practice.

Introduction: Alterations in cortical body maps (body schema), have been tied to the initiation and maintenance of a pain state.One clinical test of altered body schema is left-right discrimination or laterality, which is abnormal in people with chronic pain.To date, the prevalence of these changes in clinical practice has not been studied or reported. Materials and Methods:Patients attending outpatient physiotherapy for lower extremity injuries were recruited for the study.Following completion of consent and demographic data collection, patients completed two laterality tests of the foot.Mean score of two tests of foot laterality accuracy and speed was collected for each patient.Laterality scores were compared to current normative data to determine patients presenting with abnormal values and which clinical presenting signs and symptoms correlate to abnormal laterality scores.Results: Forty patients (female 22), participated in the study.Fourteen patients (35%) recorded an abnormal laterality score (speed or accuracy), indicating a relative high prevalence of laterality issues in patients attending outpatient physiotherapy for lower extremity injuries.Older patients and patients identifying as female were more predictive of poor laterality score, compared to other demographic and clinical variables including duration and intensity of pain, immobilization and surgery. Conclusion:Laterality deficits are common in patients attending outpatient physiotherapy for lower extremity disorders.Older adults and patients identifying as female have a higher chance of recording an abnormal laterality score.Clinicians should recognize this, test for it and use it as a guide in their treatment planning.

Primary Care Diabetes is the offi cial journal of Primary Care Diabetes Europe. The journal publishes original research articles and high-quality reviews in the fi elds of clinical care, diabetes education, nutrition, health services, psychosocial research, epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and refl ects the society's aim of improving the care for people with diabetes mellitus within the primary-care setting.

Abstract Canary structures being used as early warning indicators represent an important tool for condition and health monitoring of electronic components and systems. In this paper, printed circuit boards with canary structures based on SMD 2512 ceramic chip resistors with reduced solder pad sizes were studied. Focus of these investigations was set on thermo-mechanical and mechanical stresses caused by passive thermal cycling as well as by vibrational loads. For this purpose, experimental methods such as deformation analysis and accelerated ageing tests as well as finite element based methods were applied. In addition, an outlook on the implementation of these canary structures into dual inverter electronic control boards for electrical powertrain applications will be given.

The delivery of cancer care has never changed as rapidly and dramatically as we have seen with the coronavirus disease 2019 (COVID‐19) pandemic. During the early phase of the pandemic, recommendations for the management of oncology patients issued by various professional societies and government agencies did not recognize the significant regional differences in the impact of the pandemic. California initially experienced lower than expected numbers of cases, and the health care system did not experience the same degree of the burden that had been the case in other parts of the country. In light of promising trends in COVID‐19 infections and mortality in California, by late April 2020, discussions were initiated for a phased recovery of full‐scale cancer services. However, by July 2020, a surge of cases was reported across the nation, including in California. In this review, the authors share the response and recovery planning experience of the University of California (UC) Cancer Consortium in an effort to provide guidance to oncology practices. The UC Cancer Consortium was established in 2017 to bring together 5 UC Comprehensive Cancer Centers: UC Davis Comprehensive Cancer Center, UC Los Angeles Jonsson Comprehensive Cancer Center, UC Irvine Chao Family Comprehensive Cancer Center, UC San Diego Moores Cancer Center, and the UC San Francisco Helen Diller Family Comprehensive Cancer Center. The interventions implemented in each of these cancer centers are highlighted, with a focus on opportunities for a redesign in care delivery models. The authors propose that their experiences gained during this pandemic will enhance pre‐pandemic cancer care delivery.