Patellofemoral knee pain treatment using neuromuscular retraining of the hip musculature in an adolescent female: a case report

The purpose of this case study is to demonstrate the treatment of patella-femoral knee pain in an adolescent female athlete with emphasis on neuromuscular training of the knee and hip in synergy movement strategies. A 1.67-m, 61.5-kg, 15-year-old woman athlete reported to rehabilitation with the complaint of a 1-year history of bilateral knee pain. The patient noted that the symptoms were exacerbated with any sports-specific training. The patient played softball as an infielder. The athlete was referred by her family practice physician. After the patient was assessed, a clinical hypothesis was generated. It was thought that neuromuscular dysfunction of the hips and knees was causing faulty knee mechanics. These abnormal mechanics were presenting as patella-femoral knee pain. Initially, the athlete was assigned a home exercise program of side-lying hip abduction and lateral step-downs. At her first follow-up appointment, she noted increased symptoms that were aggravated with her home program. Upon inspecting her exercise technique, faulty step-down mechanics were contributing to her symptoms. Step-downs were discontinued, and the patient was instructed in and performed a chair squatting exercise, which was added to her home program. At her next follow-up, the patient noted being asymptomatic for 2 days. Her exercises were increased in intensity to include a Stairmaster and hip abduction and adduction on a 4-way hip machine. Eventually, over her treatment course, perturbation and proprioceptive training were initiated. By the sixth visit, the patient reported no symptoms and felt comfortable with self-management. A phone interview 3 months later indicated that the patient had no recurrent symptoms and was participating in sports without difficulty. This case demonstrates effectiveness of using hip and knee joint synergy to treat patella-femoral pain (PFP). The use of this synergy promotes proper patella–femoral alignment and improved knee mechanics. This case also is unique in the lack of physical agents and taping used to improve the patient's condition. It reinforces how exercise technique can carry over to functional athletic activities. This study provides a case for the use of hip and knee mechanical retraining in the treatment of PFP in adolescent female athletes who do not exhibit abnormal foot mechanics in weight bearing. It is important that sports medicine professionals be aware of these treatment options and are able to use them to correct these deficits in order to facilitate return to training and competition as quickly and safely as possible.     

Effectiveness of multiple muscle-site EMG biofeedback and relaxation training in reducing the aversiveness of cancer chemotherapy

A 44-year-old female cancer patient was given progressive muscle relaxation training and multiple muscle-site EMG biofeedback to reduce the conditioned negative responses she had apparently developed to her chemotherapy treatments. Following three baseline chemotherapy sessions, the patient was given relaxation training and biofeedback during four consecutive chemotherapy treatments and was asked to practice her relaxation skills daily in the hospital or at home. After the patient felt able to relax on her own, relaxation training and biofeedback were terminated and three follow-up sessions were held. Results indicated that during the chemotherapy sessions in which the patient received relaxation training and biofeedback, she showed reductions in physiological arousal (EMG, pulse rate, systolic blood pressure, and diastolic blood pressure) and reported feeling less anxious and nauseated. Moreover, these changes were maintained during the follow-up sessions. These results suggest that relaxation training plus multiple muscle-site biofeedback may be an effective adjunctive procedure for reducing some of the adverse side effects of cancer chemotherapy.     

广西近捕鸟蛛体表结构扫描电镜观察

对广西近捕鸟蛛Plesiophrictus guangxiensis进行扫描电镜观察,观察其螯肢、颚叶、跗节、生殖球、生殖沟、书肺、感觉器官、发音器及纺器等若干体表结构,为进一步研究蜘蛛的形态结构提供基础资料.     

Mental health system in China: history, recent service reform and future challenges

This paper summarizes the history of the development of Chinese mental health system; the current situation in the mental health field that China has to face in its effort to reform the system, including mental health burden, workforce and resources, as well as structural issues; the process of national mental health service reform, including how it was included into the national public health program, how it began as a training program and then became a treatment and intervention program, its unique training and capacity building model, and its outcomes and impacts; the barriers and challenges of the reform process; future suggestions for policy; and Chinese experiences as response to the international advocacy for the development of mental health.     

Teleosemantics re-examined: content,explanation and norms

This essay reviews a collection of thirteen critical essays on the work of Ruth Millikan. The collection covers a broad range of her work, focusing in particular on her account of simple intentionality, her theory of concepts and her metaphysical views. I highlight and briefly discuss three issues that crop up repeatedly though the collection: (1) Millikan’s externalism (and in particular, her emphasis on how intentional states are used, rather than how they are produced); (2) the nature of intentional explanation; and (3) the normativity of meaning.     

Identifying and managing adverse environmental health effects: 1. Taking an exposure history

PUBLIC CONCERN AND AWARENESS ARE GROWING about adverse health effects of exposure to environmental contaminants. Frequently patients present to their physicians with questions or concerns about exposures to such substances as lead, air pollutants and pesticides. Most primary care physicians lack training in and knowledge of the clinical recognition, management and avoidance of such exposures. We have found that it can be helpful to use the CH²OPD² mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) as a tool to identify a patient''s history of exposures to potentially toxic environmental contaminants. In this article we discuss why it is important to take a patient''s environmental exposure history, when and how to take the history, and how to interpret the findings. Possible routes of exposure and common sources of potentially toxic biological, physical and chemical substances are identified. A case of sick-building syndrome is used to illustrate the use of the mnemonic.CaseA 40-year-old married bookkeeper presents with a 3-year history of headaches. She describes having “tight,” bitemporal headaches almost daily that resolve after taking three 325-mg tablets of ASA. She also complains of a “spacey” feeling, difficulty concentrating and remembering, fatigue, a stuffy nose and a full feeling in her ears. Her symptoms improve on weekends and over the holidays and seem to be worse in the winter. Over the past 2 years she has noticed that she gets a stuffy nose and headaches when exposed to perfumes, tobacco smoke and automobile exhaust. Her past medical history is remarkable only for infantile eczema. Her family history is unremarkable other than her mother having hypothyroidism. She is taking no medications other than ASA, does not smoke, reports having no allergies and says she is happily married with no major family, financial or social concerns. She enjoys her work and coworkers. On physical examination she has puffy, dark circles under her eyes, there is loss of light reflex on her left ear drum, and her nasal mucosa appears edematous and erythematous. There are multiple excoriated, erythematous papules 5 mm in diameter on her face, anterior chest and anterior lower legs.Questions surrounding this case: What is sick-building syndrome and how do patients commonly present? What causes or contributes to sick-building syndrome? What are the risk factors? How should cases be managed?     

Target training

The determination of the achievement of self-regulation of hand temperature can be difficult, even with adequate baseline and control procedures. Although bidirectional training is often mentioned as a technique for thorough learning and for a convincing demonstration of temperature control, patients are sometimes unwilling or unable to lower hand temperature volitionally. This case report describes a patient who, due to failure at lowering her hand temperature, developed the target training method to convince herself of her self-regulation skill. The method may be useful in both clinical and research settings.     

Target training: a technique for assessing self-regulation of skin temperature.

The determination of the achievement of self-regulation of hand temperature can be difficult, even with adequate baseline and control procedures. Although bidirectional training is often mentioned as a technique for thorough learning and for a convincing demonstration of temperature control, patients are sometimes unwilling or unable to lower hand temperature volitionally. This case report describes a patient who, due to failure at lowering her hand temperature, developed the target training method to convince herself of her self-regulation skill. The method may be useful in both clinical and research settings.     

“Film!”—The Arab Revolutions and the Filmmaker as Amanuensis

In her recent memoir of the Egyptian revolution Ahdaf Soueif records how one day a woman came up to her on Tahrir Square and started instructing her on how to write down the “national epic” unfolding around them. Taking Soueif’s text as an allegory of the relationship between the individual and the people, I explore how an analogous process is enacted in one particular video shot in Cairo on January 25, 2011. Taken together, these two “texts” suggest the emergence of a distinctively revolutionary aesthetic, which is also a politics of obedience.     

Is Her Majesty at home?

When Queen Elizabeth is at home in Buckingham Palace, tradition has it that the Royal Standard is raised, so that all may know the fact. Although it is not crucial for most of us to know whether Her Majesty is home, it is in social insects. Endler et al. have recently shown how an ant queen signals her presence to her remote workers: she marks her eggs. This is significant because it provides insight into how queens maintain reproductive monopoly within their colonies.     

Self-directed EMG training for the control of pain and spasticity in paraplegia: a case study

A 25-year-old paraplegic woman was able to gain control of her debilitating leg and bladder spasms and abdominal pain using self-directed EMG biofeedback. The case is significant in that she previously had only cursory exposure to biofeedback as an undergraduate student and received only minimal support and direction from an instructor. She proceeded through daily home practice using a borrowed EMG unit and audiotapes from Lester Fehmi's Open Focus series. Records were kept of the frequency and intensity of her pain and spasms, as well as the frequency and procedures of her home practice. She also maintained a record of specific psychosocial events in her life, which, over time, showed a strong, consistent pattern of influence on the recurrence and severity of her symptoms. The woman's physician declared her medical progress remarkable and encouraged her biofeedback work. At 2-year follow-up, she remains virtually symptom- and medication-free. Her successful biofeedback training program provides support for the value of client-directed biofeedback in selected cases.     

Host-parasite interactions: an interview with Emily Troemel

Emily Troemel is a Professor at the University of California San Diego, where her lab uses Caenorhabditis elegans to study host–pathogen interactions and the shaping of the immune response. In this interview, Emily shared her thoughts on peer review and its role in training future scientists, and the possibility of a new form of immunity in epithelia.     

Foreseeing fates: a commentary on Manton (1928) ‘On the embryology of a mysid crustacean,Hemimysis lamornae’

Sidnie Manton became best known for her work on arthropod locomotion, and for proposing radical views on the evolution of arthropods that were accepted for a generation. However, her early training was as an embryologist, and the work that she carried out at the beginning of her career still stands as one of the major twentieth century contributions to the study of crustacean embryology. Here, I review her first major paper, largely completed while she was a graduate student, describing embryonic development in Hemimysis lamornae, a small shrimp-like animal found in the seas around the UK. The clarity of her writing and the quality of her figures set a standard that laid the basis for subsequent work, and although not all of her conclusions have stood the test of time, they remain a standard reference for work today. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society.     

Born too soon

In this Letter, the author walks through 'Memory Lane'. She reflects upon the birth, growth and developmental trajectory of her third child who was born too soon, in a major Hospital in London. Her aim is to share her knowledge and experiences with other parents and professionals. The author acknowledges the feelings which is so common amongst mothers of preterm babies i.e. that the baby does not belong to them. Moreover, she reflects upon her participation in caring for her daughter, how overwhelming it all was and her joy when her child left hospital and is a healthy teenager.     

Family,Networks and Academics

The history of anthropology is a growing field of study within the discipline itself. Our series ‘Key Informants on the History of Anthropology’ is offered as a contribution to the discussion of how anthropology, as it is understood and practised today, evolved and took shape. In this invited article, Larissa Adler Lomnitz reflects on how a cosmopolitan background aroused an interest in her in questions of social identity. Her studies of social networks in urban situations in Latin America are renowned in anthropology. Here she relates how they unfolded—and how they have been intimately connected to her family life.     

Self-directed EMG training for the control of pain and spasticity in paraplegia: A case study

A 25-year-old paraplegic woman was able to gain control of her debilitating leg and bladder spasms and abdominal pain using self-directed EMG biofeedback. The case is significant in that she previously had only cursory exposure to biofeedback as an undergraduate student and received only minimal support and direction from an instructor. She proceeded through daily home practice using a borrowed EMG unit and audiotapes from Lester Fehmi'sOpen Focus series. Records were kept of the frequency and intensity of her pain and spasms, as well as the frequency and procedures of her home practice. She also maintained a record of specific psychosocial events in her life, which, over time, showed a strong, consistent pattern of influence on the recurrence and severity of her symptoms. The woman's physician declared her medical progress remarkable and encouraged her biofeedback work. At 2-year follow-up, she remains virtually symptom- and medication-free. Her successful biofeedback training program provides support for the value of client-directed biofeedback in selected cases.     

首例圈养大熊猫产后出血的治疗及初生幼仔长途运输初探

中国保护大熊猫研究中心雅安碧峰峡基地的一只雌性大熊猫分娩后发生产后出血,采取促进子宫收缩、减少出血、利用抗菌素药物防止感染的原则对母兽进行治疗,4d后恢复正常。治疗期间取出两只初生幼仔,利用自制人工保温箱将幼仔成功地从雅安长途运回卧龙进行人工育幼;并对母兽进行育幼行为培训以保持母性行为,母兽康复后主动接受幼仔成功哺育成活。     

Contributions of Dorothy M. Skinner to the Development of Crustacean Biology

Dorothy M. Skinner's interest in the study of crustaceans grewout of her experiences as a student and teaching assistant inthe Experimental Invertebrate Zoology course at the Marine BiologicalLaboratory, Woods Hole, MA. Her early training in both biologyand chemistry was instrumental in allowing her to pursue linesof research as diverse as control of molting and regeneration,structure of the crustacean integument, and characteristicsof satellite DNAs throughout her career. Dorothy published anumber of landmark papers in crustacean biology over the years,which served to inspire the work of numerous biologists. Thebreadth and depth of her contributions was made apparent inthis symposium, in which eleven researchers presented theirnewest findings in the areas of satellite DNA, control of regenerationand molting, dynamics of muscle atrophy and reorganization,and structure and evolution of arthropod proteins.     

Blacks as me: narrative identity

This commentary responds to genetic testing of African ancestry through a series of personal narratives that reveal a complex, intimate, and individualised process of identity formation. The author discusses both how her family and others outside her family have fostered and challenged her sense of black identity. She concludes by maintaining that racial identity is not in the genes but in the world in which we live and the stories we construct and are able to maintain.