Muscle and tendon stiffness of lower extremity in older adults with fall history: Stiffness effect on physical performance and fall risk.

Changes in muscle and tendon stiffness may lead to falls in older adults by affecting joint stability and muscle function. This study aims to investigate the changes in stiffness in lower extremity muscles and tendons in the older adults with a fall history. A cross-sectional research design was followed. 25 older adults with a fall history and 26 older adults without fall history were recruited study. Stiffness of the lower extremity muscles and tendons was measured using a MyotonPRO device. Balance and functional ability of the participants were evaluated. The stiffness of all the selected muscles and tendon was lower in the older adults with a history of fall compared to controls (p<0.05). The obtained results suggest the decrease in the stiffness of the lower extremity muscles and tendon may negatively affect muscle function and joint stability/ control, and it may increase the predisposition to falling in older adults.

Dietary intakes of individuals with temporomandibular disorders: A comparative study.

OBJECTIVE: There are some studies regarding the potential effects of temporomandibular disorders (TMD) on food intake and eating habits, however the comparison of nutritional intakes and status of individuals with and without TMD have not been adequately reported. Thus, the study aimed to assess the dietary intakes of individuals with TMD, and investigate if there is a difference in nutritional intakes between healthy individuals with and without TMD. METHODS: Individuals were grouped as 'study group (with TMD)' versus 'control group (no TMD)' according to Fonseca Anamnestic Index. The Oral Health Impact Profile-14 (OHIP-14) was used to assess oral health-related quality of life. Chewing function was evaluated with the Test of Masticating and Swallowing Solids (TOMASS). A 24-h dietary recall method was used to measure daily dietary intakes of the participants, and daily energy, macro- and micronutrient intakes were calculated. In addition, all drinks and foods in dietary records were classified under a specific modification level as 'Liquid-blenderized', 'Minced-moist & soft' and 'Easy-to chew & regular solid foods'. RESULTS: The participants in the study group (30 participants) had higher OHIP-14 score (p < .01) than control group (30 participants). According to TOMASS, number of bites (p = .003) and total time (p = .007) were both higher in the study group than control group. There was no difference in the number of chewing cycles (p = .100) and number of swallowing (p = .764) between groups. No difference was detected between groups in terms of energy, protein, carbohydrate and fat intake. There was no significant difference between groups in mean percentage of energy and macronutrient intakes from modified and regular food textures (p > .05). CONCLUSION: This study showed that there was no difference between individuals with and without TMD in terms of dietary intakes. The study results suggest that nutritional status of individuals with TMD is similar with healthy individuals without TMD.

Achilles Tendon, Patellar Tendon, and Femoral Cartilage Thickness in Control vs Asymptomatic Flatfoot Young Adults.

BACKGROUND: Changes in lower extremity alignment in individuals with flatfoot may be associated with differences in morphology of the tendons or cartilage in lower extremities. The purpose of the present study was to investigate the potential association of flatfoot with the morphology of the Achilles tendon, patellar tendon, and femoral cartilage. METHODS: This study was conducted with 40 participants with flatfoot (28 females, 12 males) and 40 participants with a normal foot posture (28 females, 12 males). The thickness of the Achilles tendon (at points 2 and 3 cm proximal to the superior aspect of the calcaneus), patellar tendon (at the inferior pole of the patella and 1 cm proximal of the inferior pole of the patella), and femoral cartilage (at the intercondylar area, medial condyle, and lateral condyle) was measured by an ultrasonography device. RESULTS: The Achilles tendon thickness at 2 cm (P = .009) and 3 cm (P = .010) proximal of the superior aspect of the calcaneus was on average 4% to 6% lower in individuals with flatfoot compared with controls. The cartilage thickness at the intercondylar area (P = .005) and medial condyle (P = .018) was on average 8% to 12% greater in individuals with flatfoot; however, the cartilage thickness at the lateral condyle and patellar tendon thickness was similar in both groups. CONCLUSION: The results obtained suggest that foot posture is associated with the morphology of the Achilles tendon and femoral cartilage. LEVEL OF EVIDENCE: Level III, diagnostic comparative study.

Passive mechanical properties of extrinsic foot muscles and Achilles tendon in adults with and without pes planus.

The purpose of the present study was to investigate the changes in stiffness, tone, and elasticity of extrinsic foot muscles and Achilles tendon in adults with pes planus at rest and during standing. The study was conducted with 59 participants, 29 with pes planus and 30 with normal foot posture. The oscillation frequency (indicator of tone), dynamic stiffness (indicator of stiffness), and logarithmic decrement (related to elasticity) of the Achilles tendon, peroneus longus, tibialis anterior, and medial and lateral gastrocnemius muscles were measured with a myotonometer (MyotonPRO, Myoton AS, Estonia). The passive mechanical properties of the selected muscles and tendon were measured at rest and during standing. The oscillation frequency, dynamic stiffness, and logarithmic decrement of the peroneus longus, tibialis anterior, and medial and lateral gastrocnemius muscles were similar in individuals with and without pes planus (p < 0.05). Individuals with pes planus had higher dynamic stiffness of the Achilles tendon at rest (p = 0.042; d = 0.431), whereas they had lower dynamic stiffness of the Achilles tendon with a moderate effect size during standing compared to controls (p = 0.028; d = 0.640). The logarithmic decrement of the Achilles tendon in individuals with pes planus was significantly lower with a large effect size during standing (p = 0.025; d = 0.945). The results obtained suggest that pes planus is not related to the passive mechanical properties of the foot extrinsic muscles. A decrease in stiffness and an increase in elasticity during standing, and an increase in stiffness at rest in the Achilles tendon were found in individuals with pes planus.

Projecting health-ageing trajectories in Europe using a dynamic microsimulation model.

The extent of the challenges and opportunities that population ageing presents depends heavily on the population's health. Hence, for the development of appropriate strategies that enable countries to adopt the emerging demographic and epidemiological realities, information on future health trajectories of elderly population is a natural requirement. This study presents an innovative methodological framework for projecting the health of individuals using a dynamic microsimulation model that considers interactions between sociodemographic characteristics, health, mortality, bio-medical and behavioral risk factors. The model developed, called ATHLOS-Mic, is used to project the health of cohorts born before 1960 for the period 2015-2060 for selected European Countries using SHARE data to illustrate the possible effects of some selected risk factors and education on future health trajectories. Results show that, driven by a better educational attainment, each generation will be healthier than the previous one at same age. Also, we see that, on average, an individual of our base population will live about 18 more years since the start of the projection period, but only 5 years in good health. Finally, we find that a scenario that removes the effect of having a low level of education on individual health has the largest impact on the projected average health, the average number of years lived per person, and the average number of years lived in good health.

Association Between State-Level Criminal Justice-Focused Prenatal Substance Use Policies in the US and Substance Use-Related Foster Care Admissions and Family Reunification.

Importance: States have enacted criminal justice-related substance use policies to address prenatal substance use and protect infants from adverse health effects of parental substance use. However, little is known about the consequences of these policies for permanency outcomes among infants in the foster care system in the United States. Objectives: To evaluate the consequences of criminal justice-related prenatal substance use policies for family reunification and to examine differences in parental reunification by racial/ethnic group. Design, Setting, and Participants: In this cohort study using data from the 2005 to 2017 Adoption and Foster Care Analysis and Reporting System, 13 cohorts of infants who entered the foster care system were followed up. States with criminal justice-related prenatal substance use policies were compared with states without such policies before and after their enactment using a discrete-time hazard model adjusted for individual covariates, state, and cohort fixed effects. The sample consisted of 350 604 infants 1 year or younger who had been removed from their home because of parental drug or alcohol use. Main Outcomes and Measures: Length of time from entering the child welfare system to first reunification with a parent and hazard rates (HRs). Results: Of the 350 604 infants 1 year or younger, 182 314 (52%) were boys, 251 572 (72%) were non-Hispanic white children, and 160 927 (46%) lived in US states with a criminal justice-focused prenatal substance use policy. Among those who were reunified, 36% of the reunifications occurred during the first year and 45% in the second year. Foster care infants who were removed from their homes because of parental substance use who live in states that have adopted criminal justice-oriented policies had a lower chance of reunification with a parent compared with states that have not adopted those policies (HR, 0.95; 95% CI, 0.94-0.96). Specifically, non-Hispanic black children who live in a state that has adopted criminal justice-oriented policies had a lower chance of reunification with a parent than non-Hispanic black children who live in a state that has not adopted those policies (HR, 0.87; 95% CI, 0.81-0.94). Conclusions and Relevance: Given the child welfare system's legal mandate to make every effort toward parental reunification, a more comprehensive treatment and supportive policy approach toward parental substance use might be warranted.